Active NPI
Amber Lyn Rodriguez, LCSW
- Clinical Social Worker
- Colorado Springs, CO
National Provider Identifier
1962994343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 104792
- Practice address
- 11332 Pensive PT
Colorado Springs, CO 80921-4304 - Phone
- (909) 279-7997
- NPI assigned
- Jun 1, 2018
- 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 | 104792 | CA | Primary |
Addresses
Primary practice location
11332 Pensive PT
Colorado Springs, CO 80921-4304
Mailing address
11332 Pensive PT Apt 209
Colorado Springs, CO 80921-4306
Phone (909) 279-7997
Other practice location 1
1035 W Ramsey St Ste A
Banning, CA 92220-4400
Phone (951) 849-0506
Other practice location 2
325 W Hospitality Ln Ste 103
San Bernardino, CA 92408-3210
Phone (909) 266-2700
Other names 1
- Ms. Amber Lyn Manfredi
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Clinics | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Upland, CA
- NPI 1487916821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1962994343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11332 PENSIVE PT APT 209",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809214306",
"telephone_number": "909-279-7997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11332 PENSIVE PT",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809214304",
"telephone_number": "909-279-7997"
}
],
"practiceLocations": [
{
"address_1": "1035 W Ramsey St Ste A",
"address_purpose": "LOCATION",
"city": "Banning",
"state": "CA",
"postal_code": "922204400",
"country_code": "US",
"telephone_number": "951-849-0506",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "325 W Hospitality Ln Ste 103",
"address_purpose": "LOCATION",
"city": "San Bernardino",
"state": "CA",
"postal_code": "924083210",
"country_code": "US",
"telephone_number": "909-266-2700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "AMBER",
"middle_name": "LYN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-01",
"last_updated": "2022-03-21",
"certification_date": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "104792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMBER",
"last_name": "MANFREDI",
"middle_name": "LYN",
"prefix": "MS.",
"credential": "ASW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.