AMY J WILLIS (NPI# 1235229980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235229980 |
| Entity Type | Individual |
| Full Name | AMY J WILLIS |
| Other Name | AMY CAROL JOHNSON |
| Credential | LCSW |
| Practice Address |
1030 Jefferson Ave Memphis TN 38104-2127 |
| Mailing Address |
5143 Tarrytown Dr Memphis TN 38117-2125 |
| Practice Telephone | 9015238990 |
| Mailing Telephone | 6155008400 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2018-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LSW0000004269 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3698356 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538786694 | Amy Willis | Dietitian, Registered | 11711 Livingston Rd, Fort Washington, MD 20744-5151 | 2020-07-06 |
| 1992281596 | Amy Willis | Counselor | 1742 Cheryl St, Clarksdale, MS 38614-7218 | 2018-07-17 |
| 1689086803 | Amy Dee Willis | Chiropractor | 2829 Dallas Street, Kennesaw, GA 30144 | 2014-05-22 |
| 1881950996 | Amy Leigh Willis | Pediatrics | 13123 E 16th Ave, Children's Hospital Colorado, Aurora, CO 80045-7106 | 2012-04-03 |
| 1205100336 | Amy Watson Willis | Rehabilitation Practitioner | 111 S Railroad Ave, Dunn, NC 28334-4853 | 2012-03-07 |
| 1003199449 | Amy Willis | Psychologist | 2399 E Walton Blvd, Auburn Hills, MI 48326-1955 | 2011-09-22 |
| 1871707794 | Amy Lea Willis | Occupational Therapist | 14906 Jefferson Davis Hwy, Woodbridge, VA 22191-4016 | 2007-05-09 |
| 1134210909 | Amy Willis | Occupational Therapist | 4560 Se International Way, Milwaukie, OR 97222 | 2006-09-27 |
| 1801997093 | Amy Batt Willis | Obstetrics & Gynecology | 119 Hendersonville Rd, Asheville, NC 28803-2868 | 2006-09-26 |
| 1215943220 | Amy Catherine Willis | Psychologist | 1400 Blackhorse Hill Rd, Va Medical Center, Coatesville, PA 19320-2040 | 2006-07-31 |
| Street Address |
1030 JEFFERSON AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982697025 | Katherine Denton Sanford | Optometrist | 1030 Jefferson Ave, Mail Code 112d, Memphis, TN 38104-2127 | 2005-08-24 |
| 1528667938 | Mckenzie Bahl | Recreation Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-19 |
| 1427656834 | Phillip David Resuggan | Music Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2193 | 2020-10-16 |
| 1962009159 | Rachel Diann Roberts | Nurse Anesthetist, Certified Registered | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-01 |
| 1225643018 | Melanie Warren | Nurse Practitioner | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-09-09 |
| 1942828892 | Brady Cole | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-08 |
| 1457978595 | Mariko Thel | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-05 |
| 1215554910 | Weston Paul Keen | Pharmacy | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-29 |
| 1225655236 | Rebecca Fong | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-26 |
| 1225653660 | Brandy Hollums | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942814306 | Hinda Rashki Osina | Social Worker | 5344 Brantford Ave, Memphis, TN 38120-2440 | 2020-09-03 |
| 1740893130 | Longmire Counseling Services, LLC | Social Worker | 1331 Union Ave Ste 1012, Memphis, TN 38104-7509 | 2020-08-26 |
| 1619595519 | Pha'meshia Calico | Social Worker | 3687 Paradise Lake Drive, Memphis, TN 38115-3811 | 2020-07-08 |
| 1609404599 | Amanda Lorelle Gitomer | Social Worker | 5395 Estate Office Dr Ste 15395, Memphis, TN 38119-0614 | 2020-03-28 |
| 1730748476 | Anne Renee Dillard | Social Worker | 5050 Poplar Ave Ste 1118, Memphis, TN 38157-1118 | 2019-06-06 |
| 1477111797 | Karen Elaine Dotson | Social Worker | 1039 Bluebird Rd, Memphis, TN 38116-4003 | 2019-06-01 |
| 1689150393 | Lauren Byrd Hansen | Social Worker | 4136 Philwood Ave, Memphis, TN 38122-3913 | 2018-07-16 |
| 1487164356 | Robert Brian Dove | Social Worker | 4515 Poplar Ave Ste 419, Memphis, TN 38117-7508 | 2017-10-05 |
| 1760991038 | Crystal Dinesse Deberry | Social Worker | 4821 American Way Ste 200g, Memphis, TN 38118-2471 | 2017-09-29 |
| 1780103010 | Brittney Scantling | Social Worker | 1689 Nonconnah Blvd Ste 100, Memphis, TN 38132-2111 | 2017-09-19 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.