Amanda Phares, BSW, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.1000103 Issued in OH

Practice address

2285 Benden Dr
Wooster, OH 44691-2568

Phone

(330) 263-0380

NPI assigned

Sep 20, 2010

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 names 1

• Amanda Diffenderfer Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1871801274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 BENDEN DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912568",
            "telephone_number": "330-263-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 BENDEN DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912568",
            "telephone_number": "330-263-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHARES",
        "first_name": "AMANDA",
        "credential": "BSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1000103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DIFFENDERFER",
            "credential": "BSW, LSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kristina M Pettorini, BA, QMHS
• Desire Peyatt
• Virginia May Pfaff, MA,
• Carrie Ann Pfister
• Kayla Phanthavong
• Pharmacy Operations, Inc
• Lisa Marie Philippon, D.P.T.
• Amanda L Phillips
• Anna C. Phillips, BSW, LSW
• Brittany Marie Phillips, MSW, LSW

• Clinical Social Worker in Wooster, OH
• Providers in Wooster, 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 Apr 17, 2017; 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.