Individual provider Active NPI

Amanda Chase Duffy, L.I.C.S.W.

  • Clinical Social Worker
  • Somerville, MA
National Provider Identifier
1972738417
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1022293 Issued in MA
Practice address
403 Highland Ave
Suite 211
Somerville, MA 02144-2530
Phone
(617) 666-5800
Fax
(617) 666-5832
NPI assigned
May 28, 2009
Last updated
May 28, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2009

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 1022293 MA Primary

Addresses

Primary practice location

403 Highland Ave
Suite 211
Somerville, MA 02144-2530

Mailing address

403 Highland Ave
Suite 211
Somerville, MA 02144-2530
Phone (617) 666-5800

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

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1972738417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 HIGHLAND AVE",
            "address_2": "SUITE 211",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442530",
            "telephone_number": "617-666-5800",
            "fax_number": "617-666-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 HIGHLAND AVE",
            "address_2": "SUITE 211",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442530",
            "telephone_number": "617-666-5800",
            "fax_number": "617-666-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "AMANDA",
        "middle_name": "CHASE",
        "name_prefix": "Ms.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1022293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.