Amanda Fay Pruitt, LMSW
Individual provider Active NPI Social Worker · Readyville, TN
NPI 1942451968 · NPPES record last updated Apr 21, 2010
Key facts
- NPI
- 1942451968
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- LSW0000007020 (TN)
- Practice address
- 5353 Ferrell Hollow Rd
Readyville, TN 37149-4887 - Phone
- (615) 409-6220
- Fax
- (615) 409-6220
- NPI assigned
- Oct 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSW0000007020 | TN | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LSW0000007020 | TN | Yes |
Addresses
Primary practice location
5353 Ferrell Hollow Rd
Readyville, TN 37149-4887
Mailing address
5353 Ferrell Hollow Rd
Readyville, TN 37149-4887
Phone (615) 409-6220
Other providers in Readyville, TN
All providers in Readyville, TN · Social Worker in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.