Amy Marie Shull, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1303654 SUPV Issued in OH

Practice address

8904 Brookside Ave
West Chester, OH 45069-3139

Phone

(513) 644-1030

Fax

(513) 644-1025

NPI assigned

Mar 16, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Focus on Youth, Inc.

  • Community/Behavioral Health Agency
  • West Chester, OH
  • NPI 1093139305
  NPD (past)

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1952762023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8904 BROOKSIDE AVE",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450693139",
            "telephone_number": "513-644-1030",
            "fax_number": "513-644-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8904 BROOKSIDE AVE",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450693139",
            "telephone_number": "513-644-1030",
            "fax_number": "513-644-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1303654 SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylee Jo Sherrill, RN
• Pranav B. Sheth, M. D.
• McKenna Shives
• Matthew Shong
• Richard Francis Shonk, M.D.
• Agnes Sibanda, LPN
• Omar Mahmud Siddiqi, M.D
• Natalie Siegele, MSW, LSW
• Matthew Sigler
• Lauren Lee Sigmon

• Clinical Social Worker in West Chester, OH
• Providers in West Chester, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.