Wellness With Ami LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WELLNESS WITH AMI LLC

Practice address

3331 Stanley Ave Ste a
Dayton, OH 45404-2022

Phone

(937) 203-0975

Fax

(855) 595-2759

NPI assigned

Apr 14, 2022

Organization subpart

No

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

Authorized official

Name

Ami Wallace-Benning, LISW-SNPI 1790239390

Title

Owner/Clinical Social Worker

Phone

(937) 203-0975

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ami E Wallace-Benning, LISW

  • Clinical Social Worker
  • Dayton, OH
  • NPI 1790239390
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657843200000",
    "number": "1891438313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454040549",
            "telephone_number": "937-203-0975",
            "fax_number": "855-595-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 STANLEY AVE STE A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454042022",
            "telephone_number": "937-203-0975",
            "fax_number": "855-595-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS WITH AMI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A",
        "authorized_official_last_name": "WALLACE-BENNING",
        "authorized_official_first_name": "AMI",
        "authorized_official_title_or_position": "OWNER/CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "937-203-0975",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0483745",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Dayton, OH
• Providers in Dayton, 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 Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.