Active NPI
Amanda Kathryn Blue, LISW
- Clinical Social Worker
- Westlake, OH
National Provider Identifier
1811286917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.1100046
- Practice address
- 1800 Halls Carriage Path
Westlake, OH 44145-2031 - Phone
- (440) 289-1367
- NPI assigned
- Mar 30, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I.1100046 | OH | Primary |
Addresses
Primary practice location
1800 Halls Carriage Path
Westlake, OH 44145-2031
Mailing address
1800 Halls Carriage Path
Westlake, OH 44145-2031
Phone (440) 289-1367
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 |
|---|---|---|---|
| I.1100046 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301443200000",
"number": "1811286917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 HALLS CARRIAGE PATH",
"city": "WESTLAKE",
"state": "OH",
"postal_code": "441452031",
"telephone_number": "440-289-1367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 HALLS CARRIAGE PATH",
"city": "WESTLAKE",
"state": "OH",
"postal_code": "441452031",
"telephone_number": "440-289-1367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUE",
"first_name": "AMANDA",
"middle_name": "KATHRYN",
"name_prefix": "Ms.",
"credential": "LISW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-30",
"last_updated": "2011-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.1100046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westlake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.