Amy Jo Hallett, LMSW, LCSW, LISW-S

Primary specialty

Social WorkerTaxonomy code 104100000X

License

59069 Issued in TX

Practice address

4111 Bradley Circle NW
Suite 150
Canton, OH 44718

Phone

(330) 617-2324

NPI assigned

Sep 26, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Emerald Pine, Grief & Trauma Services, LLC

  • Clinical Social Worker
  • Canton, OH
  • NPI 1154036564
  NPD Authorized official

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1992108534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 BRADLEY CIRCLE NW",
            "address_2": "SUITE 150",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-617-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 BRADLEY CIRCLE NW",
            "address_2": "SUITE 150",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-617-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLETT",
        "first_name": "AMY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "LMSW, LCSW, LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010567",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.210318189.SUPV",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "59069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Kye Hall II
• Sara Hallam, NP
• Annette Kay Halle, LSW
• Jeffrey Haller
• Lisa Haller
• Cynthia Marie Hallgren, P.T.
• Taylor Rose Hallworth
• Sirilak Ham, APRN-CNP
• Alissa Christine Hamburger, OTR/L
• Jacquelyn Hamby, LPC

• Social Worker in Canton, OH
• Providers in Canton, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.

Verify at the official NPI Registry.