Individual provider Active NPI

Amanda Marie Frey, LGSW

  • Social Worker
  • Salisbury, MD
National Provider Identifier
1851890479
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
21076 Issued in MD
Practice address
1113 Healthway Dr
Salisbury, MD 21804-4470
Phone
(410) 334-6961
NPI assigned
Feb 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 21076 MD
Social Worker 104100000X 21076 MD Primary

Addresses

Primary practice location

1113 Healthway Dr
Salisbury, MD 21804-4470

Mailing address

1113 Healthway Dr
Salisbury, MD 21804-4470
Phone (410) 334-6961

Other identifiers 1

IdentifierTypeStateIssuer
609550001MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210827001641 MD Practitioner - Clinical Social Worker 2062817158 Reassigns benefits to 1 organization
I20260416000252 VA Practitioner - Clinical Social Worker 2062817158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 318
Tasley, VA 23441

PO Box
Suite 318
Tasley, VA 23441-0318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21076MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Mental Wellness CurrentSince Aug 1, 2022 Accepting new patients

Locations

1411 Wesley Dr
Salisbury, MD 21801
Phone (410) 642-4011

Organizations & group practices 2

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": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1851890479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 HEALTHWAY DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218044470",
            "telephone_number": "410-334-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 HEALTHWAY DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218044470",
            "telephone_number": "410-334-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREY",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "21076",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "21076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609550001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.