Active NPI
Amanda Lynn Manteufel, LSW
- Social Worker
- Bemidji, MN
National Provider Identifier
1992982045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 18825
- Practice address
- 722 15TH St NW
Bemidji, MN 56601-2528 - Phone
- (612) 226-1200
- NPI assigned
- Jan 30, 2008
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 18825 | MN | Primary |
Addresses
Primary practice location
722 15TH St NW
Bemidji, MN 56601-2528
Mailing address
722 15TH St NW
P.O. Box 640
Bemidji, MN 56601-2528
Phone (612) 226-1200
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 |
|---|---|---|---|
| 18825 | MN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1992982045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "722 15TH ST NW",
"address_2": "P.O. BOX 640",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566012528",
"telephone_number": "612-226-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "722 15TH ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566012528",
"telephone_number": "612-226-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANTEUFEL",
"first_name": "AMANDA",
"middle_name": "LYNN",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-30",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "18825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bemidji, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.