Individual provider Active NPI

Amanda Leake, LCSW

  • Clinical Social Worker
  • Charlottesville, VA
National Provider Identifier
1962371419
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904019170 Issued in VA
Practice address
1562 Dairy Rd
Charlottesville, VA 22903-1304
Phone
(434) 960-9973
NPI assigned
Nov 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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 0904019170 VA Primary

Addresses

Primary practice location

1562 Dairy Rd
Charlottesville, VA 22903-1304

Mailing address

2918 Hanes Ave Unit B
Richmond, VA 23222-3607
Phone (434) 245-2889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904019170VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1962371419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 HANES AVE UNIT B",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232223607",
            "telephone_number": "434-245-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1562 DAIRY RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229031304",
            "telephone_number": "434-960-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAKE",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904019170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.