Individual provider Active NPI

Amanda Weissman, LCSW

  • Clinical Social Worker
  • Dunn, NC
National Provider Identifier
1902296015
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P011074 Issued in NC
Practice address
710 W Broad St
Dunn, NC 28334
Phone
(919) 440-7057
NPI assigned
Jan 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P011074 NC Primary

Addresses

Primary practice location

710 W Broad St
Dunn, NC 28334

Mailing address

710 W Broad St
Dunn, NC 28334-4702
Phone (919) 440-7057

Other practice location 1

1822 E Nc Highway 54 Ste 300
Durham, NC 27713
Phone (919) 474-6400

Other practice location 2

2313 Executive Cir Ste C
Greenville, NC 27834-3744
Phone (252) 215-5700

Other practice location 3

1822 E Nc Highway 54 Ste 300
Durham, NC 27713
Phone (919) 474-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P011074NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southmountain Children and Family Services Clinical PastSince Sep 1, 2019 Accepting new patients
Southmountain Children and Family Services PastSince Sep 1, 2019 Accepting new patients

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": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1902296015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W BROAD ST",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283344702",
            "telephone_number": "919-440-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W BROAD ST",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "28334",
            "telephone_number": "919-440-7057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1822 E Nc Highway 54 Ste 300",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "27713",
            "country_code": "US",
            "telephone_number": "919-474-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2313 Executive Cir Ste C",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278343744",
            "country_code": "US",
            "telephone_number": "252-215-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1822 E Nc Highway 54 Ste 300",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "27713",
            "country_code": "US",
            "telephone_number": "919-474-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISSMAN",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.