Active NPI
Amanda Leake, LCSW
- Clinical Social Worker
- Charlottesville, VA
National Provider Identifier
1962371419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904019170
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0904019170 | VA | MD | Clinical 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.