Active NPI
Amanda J Watts, LISW
- Clinical Social Worker
- Columbus, OH
National Provider Identifier
1902390263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 195 N Grant Ave Ste 250
Columbus, OH 43215-2855 - Phone
- (440) 260-8300
- NPI assigned
- Jun 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
195 N Grant Ave Ste 250
Columbus, OH 43215-2855
Mailing address
434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 234-2006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindfully, LLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| Coleman Professional Services, Inc. | Clinical | Current | Accepting new patients |
| Mindfully, LLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
Locations
1251 Nilles Rd
Ste 5
Fairfield, OH 45014
Phone (732) 993-4599
5982 Rhodes Rd
Kent, OH 44240
Phone (330) 676-6875
Organizations & group practices 3
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": "1529452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712188800000",
"number": "1902390263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "434 EASTLAND RD",
"city": "BEREA",
"state": "OH",
"postal_code": "440171217",
"telephone_number": "440-234-2006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 N GRANT AVE STE 250",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432152855",
"telephone_number": "440-260-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "AMANDA",
"middle_name": "J",
"credential": "LISW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-20",
"last_updated": "2024-04-04",
"certification_date": "2024-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.