Ami E Wallace-Benning, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1600177 Issued in OH

Practice address

3331 Stanley Ave Ste a
Dayton, OH 45404-2022

Phone

(937) 203-0975

NPI assigned

Aug 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wellness With Ami LLC

  • Clinical Social Worker
  • Dayton, OH
  • NPI 1891438313
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1790239390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454040549",
            "telephone_number": "937-203-0975",
            "fax_number": "855-595-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 STANLEY AVE STE A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454042022",
            "telephone_number": "937-203-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE-BENNING",
        "first_name": "AMI",
        "middle_name": "E",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0183087",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shae Montana Walker
• Shani Walker
• Sherica Walker
• William Wesley Walker III, LPCC
• Kathy D Walkup-King
• Terrilyn M. Wallace-Jett
• Alice Faye Wallace, RN
• Alicia M Wallace
• Alisha Wallace, DPM
• Betty Wallace

• Clinical Social Worker in Dayton, OH
• Providers in Dayton, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.