Amanda Lois Creel Banta, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5110C-S Issued in AL

Practice address

517 Energy Center Blvd Ste 1302
Northport, AL 35473-5810

Phone

(205) 553-9171

Fax

(334) 218-5815

NPI assigned

Feb 19, 2024

Last updated

Mar 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amh Enterprises LLC

  dba Aaron M. Hawkins M.D.

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1588229843
  Medicare reassignment NPD

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1942065909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 ENERGY CENTER BLVD STE 1302",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735810",
            "telephone_number": "205-532-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 ENERGY CENTER BLVD STE 1302",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735810",
            "telephone_number": "205-553-9171",
            "fax_number": "334-218-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTA",
        "first_name": "AMANDA",
        "middle_name": "LOIS CREEL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "5110C-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anissa R Ball
• Constance Ball, REGISTERED NURSE
• Bama Orthotic Center
• Bama Pedicatrics LLC
• Betty Jean Banks, RN
• Michael R. Barlow, M.D.
• James Talmadge Barnett Jr., M.D.
• Jillian Smith Barnette, CRNP
• Andrea Austin Barry, CRNP
• Caitlyn Noel Barton, CRNP

• Clinical Social Worker in Northport, AL
• Providers in Northport, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.

Verify at the official NPI Registry.