Individual provider Active NPI

Amy Lynne Stern, LCSW

  • Clinical Social Worker
  • Avondale Estates, GA
National Provider Identifier
1952445306
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00002451 Issued in GA
Practice address
3164 Kensington Rd
Avondale Estates, GA 30002-1456
Phone
(404) 643-9939
Fax
(404) 296-1667
NPI assigned
Feb 19, 2007
Last updated
Aug 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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 00002451 GA Primary

Addresses

Primary practice location

3164 Kensington Rd
Avondale Estates, GA 30002-1456

Mailing address

3164 Kensington Rd
Avondale Estates, GA 30002-1456
Phone (404) 643-9939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20110210000266 GA Practitioner - Clinical Social Worker 7214117134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Resolve Psychotherapy, LLCGroup PAC ID 8426238387, 2 clinicians

Practice addresses (Care Compare)

3164 Kensington Rd
Avondale Estates, GA 30002-1456
Phone (404) 844-1691

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00002451GAMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1952445306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3164 KENSINGTON RD",
            "city": "AVONDALE ESTATES",
            "state": "GA",
            "postal_code": "300021456",
            "telephone_number": "404-643-9939",
            "fax_number": "404-296-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3164 KENSINGTON RD",
            "city": "AVONDALE ESTATES",
            "state": "GA",
            "postal_code": "300021456",
            "telephone_number": "404-643-9939",
            "fax_number": "404-296-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "AMY",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "00002451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale Estates, GA

Sources for this page

Verify at the official NPI Registry.