Individual provider Active NPI

Amanda Maccallum-Gamble, MSW, LCSW-C

  • Clinical Social Worker
  • Silver Spring, MD
National Provider Identifier
1912939299
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09278 Issued in MD
Practice address
1128 Heartfields Dr
Silver Spring, MD 20904-2124
Phone
(301) 622-2770
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904003955 VA
Clinical Social Worker 1041C0700X 09278 MD Primary

Addresses

Primary practice location

1128 Heartfields Dr
Silver Spring, MD 20904-2124

Mailing address

1128 Heartfields Dr
Silver Spring, MD 20904-2124
Phone (301) 622-2770

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904003955VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1912939299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 HEARTFIELDS DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042124",
            "telephone_number": "301-622-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 HEARTFIELDS DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042124",
            "telephone_number": "301-622-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCALLUM-GAMBLE",
        "first_name": "AMANDA",
        "credential": "MSW, LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003955",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "09278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.