Amanda Welch, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

088541 Issued in NY

Practice address

35 Longwood Rd
Middle Island, NY 11953-2045

Phone

(631) 924-0008

NPI assigned

Sep 25, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda Dietrich Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21444/brand/1/csg/1/fhir/r4
• Direct secure messaging: amanda.welch.1@21444.direct.athenahealth.com

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.

• Just Kids Diagnostic and Treatment Center Inc

  • Clinic/Center
  • Middle Island, NY
  • NPI 1265570493
  Medicare reassignment NPD
• Just Kids Early Childhood Learning Center

  • Licensed Practical Nurse
  • Middle Island, NY
  • NPI 1528786076
  NPD
• Family Service League, Inc.

  • Clinic/Center
  • Bay Shore, NY
  • NPI 1730349556
  NPD (past)

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1871963470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119530012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 LONGWOOD RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532045",
            "telephone_number": "631-924-0008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Roanoke Ave",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "119012706",
            "country_code": "US",
            "telephone_number": "631-369-0104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELCH",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-25",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "088541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DIETRICH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terrence Allen Walsh
• Carolyn Wasik-Petersen, LCSW-R
• Kaitlyn Amber Watson
• Malka Dina Weiss
• Veronica Lynn Wekerle, B.A.
• Mayobanex Wentworth
• Laura Werler, D.P.T.
• Kristen Anne Werner, MASTERS DEGREE
• Melissa K Westerlund
• Patricia A Wetsell, RPA-C

• Social Worker in Middle Island, NY
• Providers in Middle Island, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.