Individual provider Active NPI

Amanda N Danison

  • Clinical Social Worker
  • Pickerington, OH
National Provider Identifier
1922463264
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I1502445 Issued in OH
Practice address
140 W Borland St Ste 300
Pickerington, OH 43147-1576
Phone
(614) 344-8488
NPI assigned
Dec 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 I1502445 OH Primary

Addresses

Primary practice location

140 W Borland St Ste 300
Pickerington, OH 43147-1576

Mailing address

1209 Hill Rd N Ste 289
Pickerington, OH 43147-7008
Phone (614) 344-8488

Other identifiers 1

IdentifierTypeStateIssuer
0221985MedicaidOH

Other names 1

  • Amanda N. Borders Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 1, 2025 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I1502445OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Graceful Journey Therapy, LLC Clinical CurrentSince Jun 30, 2024 Accepting new patients

Locations

1209 Hill Rd N
Pickerington, OH 43147
Phone (614) 344-8488

140 W Borland St
Ste 300
Pickerington, OH 43147
Phone (614) 344-8488

Organizations & group practices 1

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": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1922463264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 HILL RD N STE 289",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431477008",
            "telephone_number": "614-344-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W BORLAND ST STE 300",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431471576",
            "telephone_number": "614-344-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANISON",
        "first_name": "AMANDA",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1502445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0221985",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BORDERS",
            "middle_name": "N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pickerington, OH

Sources for this page

Verify at the official NPI Registry.