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NPI · 1174773469 · NPPES-sourced

Amanda Blake Licsw, Mssw

ActiveClinical Social Worker
NPI Number
1174773469
Type 1 · Individual
Taxonomy Code
1041C0700X
Contact
(701) 738-8363
License ND · 4753
Last Updated
Enumerated
Primary practice addressND · 58201-4010
2808 17th Ave SGrand Forks, ND 58201-4010
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Also known as

  • Formerly known asJimenez, Amanda

Source: NPPES public registry.

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About this NPIWhat this record shows.

NPI 1174773469 is registered to Amanda Blake Licsw, Mssw, a Clinical Social Worker practising at 2808 17th Ave S in Grand Forks, North Dakota. Clinical Social Worker is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy. Amanda Blake Licsw, Mssw has been enumerated in the National Provider Identifier (NPI) registry since 2008.

Provider type
Individual (Type 1)
Status
Active
Enumerated
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Secondary identifiers

Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.

Medicaid

Source: NPPES public registry.

Medicare enrollment

This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Practitioner

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Amanda Blake Licsw, Mssw accepts. To confirm in-network status with your specific health plan, contact Amanda Blake Licsw, Mssw directly at (701) 738-8363.

Frequently asked

Yes. NPI 1174773469 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Clinical Social Worker is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (701) 738-8363.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Amanda Blake Licsw, Mssw is a Type-1 individual NPI.

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Quick facts

Provider typeIndividual
Taxonomy1041C0700X
Last updated
Enumerated
StatusActive
Partneri
partner offer
Tools for healthcare teams.
Curated partner offers for clinics and front-desk staff.
Explore partners →
Affiliate placement. We may earn a commission.
Sponsored

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1 record · same addressOther providers at this location.

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Same specialtyOther Clinical Social Worker providers in North Dakota.

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Adjacent in the NPPES enumeration sequenceNPIs enumerated around this one.

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