Active NPI
Amanda Goodfellow, LMSW
- Social Worker
- Plattsburgh, NY
National Provider Identifier
1780006320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 091049
- Practice address
- 101 Broad St
Research Foundation of Suny
Plattsburgh, NY 12901-2637 - Phone
- (518) 564-3377
- Fax
- (518) 564-2328
- NPI assigned
- Jan 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 091049 | NY | Primary |
Addresses
Primary practice location
101 Broad St
Research Foundation of Suny
Plattsburgh, NY 12901-2637
Mailing address
101 Broad St
Research Foundation of Suny
Plattsburgh, NY 12901-2637
Phone (518) 564-3377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 091049 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389830400000",
"number": "1780006320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BROAD ST",
"address_2": "RESEARCH FOUNDATION OF SUNY",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "129012637",
"telephone_number": "518-564-3377",
"fax_number": "518-564-2328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BROAD ST",
"address_2": "RESEARCH FOUNDATION OF SUNY",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "129012637",
"telephone_number": "518-564-3377",
"fax_number": "518-564-2328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODFELLOW",
"first_name": "AMANDA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-16",
"last_updated": "2014-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "091049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plattsburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.