Individual provider Active NPI

Amanda Silva, LCSW

  • Clinical Social Worker
  • Sebastopol, CA
National Provider Identifier
1780367870
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114108 Issued in CA
Practice address
2264 Green Hill Rd
Sebastopol, CA 95472-9034
Phone
(707) 823-3385
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 114108 CA Primary

Addresses

Primary practice location

2264 Green Hill Rd
Sebastopol, CA 95472-9034

Mailing address

211 Stony Point Rd Apt G
Santa Rosa, CA 95401-5902
Phone (707) 364-5494

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

LicenseStateTypeSpecialty
114108CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marvin Behavioral Health Ca PC Clinical Past Accepting new patients
Marvin Behavioral Health Ma PC Clinical Past Accepting new patients
The Camp Recovery Center, LLC PastSince Aug 13, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1780367870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 STONY POINT RD APT G",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015902",
            "telephone_number": "707-364-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2264 GREEN HILL RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954729034",
            "telephone_number": "707-823-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVA",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "114108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.