Amanda Michelle Jackman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006036A Issued in IN

Practice address

121 E 3Rd St
Rushville, IN 46173-2208

Phone

(765) 932-5905

NPI assigned

Apr 10, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1891292579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7347 S BASE RD",
            "city": "MILROY",
            "state": "IN",
            "postal_code": "461569757",
            "telephone_number": "765-561-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E 3RD ST",
            "city": "RUSHVILLE",
            "state": "IN",
            "postal_code": "461732208",
            "telephone_number": "765-932-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006036A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Hoeing
• Hook-Superx LLC
• Jon Monroe Hopkins, M.D.
• Gregory Edmund Hyde, M.D., PH.D.
• Indiana Physician Management-Rush, LLC
• Kurt Leon Jacobs, DO
• Adam Jarman
• Allison Nicole Ellen Jett
• Johnson Memorial Hospital
• Kimberly Dawn Justus, MA.,MHC

• All providers in Rushville, IN
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.