Individual provider Active NPI

Amy Marie Mansfield, BS

  • Clinical Social Worker
  • Adrian, MI
National Provider Identifier
1952745069
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801097309 Issued in MI
Practice address
3306 Northmor Dr E
Adrian, MI 49221-9139
Phone
(517) 403-0757
NPI assigned
Apr 19, 2013
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Social Worker 1041C0700X 6801097309 MI Primary

Addresses

Primary practice location

3306 Northmor Dr E
Adrian, MI 49221-9139

Mailing address

3306 Northmor Dr E
Adrian, MI 49221-9139
Phone (517) 403-0757

Other practice location 1

1001 S Raisinville Rd
Monroe, MI 48161-9754
Phone (734) 384-0327

Other practice location 2

7901 4th St N
St Petersburg, FL 33702-4305
Phone (616) 327-2405

Other practice location 3

6220 Belmont Ave NE
Belmont, MI 49306-9912
Phone (616) 327-2405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200612000556 MI Practitioner - Clinical Social Worker 0749602183 Reassigns benefits to 2 organizations
I20210604000106 FL Practitioner - Clinical Social Worker 0749602183 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
6801097309MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Telebehavioral Health US Clinical CurrentSince Apr 20, 2020 Accepting new patients
RMJ1 CurrentSince Oct 16, 2023 Accepting new patients
Carla Miller Ma MSW Clinical PastSince Apr 20, 2020 Accepting new patients

Locations

7901 4th St N
Ste 300
St Petersburg, FL 33702
Phone (813) 575-1161

5331 Plymouth Rd
Ann Arbor, MI 48105
Phone (734) 412-7300

6220 Belmont Ave NE
Unit 26
Belmont, MI 49306

Organizations & group practices 3

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": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1952745069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 NORTHMOR DR E",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492219139",
            "telephone_number": "517-403-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3306 NORTHMOR DR E",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492219139",
            "telephone_number": "517-403-0757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 S Raisinville Rd",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "MI",
            "postal_code": "481619754",
            "country_code": "US",
            "telephone_number": "734-384-0327",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 4th St N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337024305",
            "country_code": "US",
            "telephone_number": "616-327-2405",
            "fax_number": "616-259-4214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6220 Belmont Ave NE",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "MI",
            "postal_code": "493069912",
            "country_code": "US",
            "telephone_number": "616-327-2405",
            "fax_number": "616-259-4214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSFIELD",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.