Individual provider Active NPI

Amanda Louise Jankoli

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1942789102
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW2410356 Issued in MA
Practice address
6 Edgerly PL FL 3
Boston, MA 02116-5327
Phone
(617) 286-6513
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X LCSW2410356 MA Primary

Addresses

Primary practice location

6 Edgerly PL FL 3
Boston, MA 02116-5327

Mailing address

249 3Rd St
Cambridge, MA 02142-1392
Phone (401) 749-2380

Other names 1

  • Amanda Louise Kalander Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20260105002663 MA Practitioner - Clinical Social Worker 3971099458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

169 Madison Ave
New York, NY 10016-5101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW2410356MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Third Space Therapy PLLC Mental Health CurrentSince Oct 30, 2025 Accepting new patients
New York State Health Medical PC Mental Health Past Accepting new patients

Locations

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

169 Madison Ave
Ste 11299
New York, NY 10016
Phone (833) 244-4878

Organizations & group practices 2

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": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1942789102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 3RD ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021421392",
            "telephone_number": "401-749-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 EDGERLY PL FL 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165327",
            "telephone_number": "617-286-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANKOLI",
        "first_name": "AMANDA",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LCSW2410356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "KALANDER",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.