NPI 1295766186 · live from the CMS NPI Registry
Amy B Anderson, MSW
Social Worker, Clinical in Kenosha, WI. National Provider Identifier 1295766186, active.
NPI record
| NPI | 1295766186 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 4109 67th St, Kenosha, WI 53142 |
| Practice phone | 262-652-9830 |
| Enumerated | July 6, 2006 |
| Last updated | November 25, 2008 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 2045 (WI) |
| Social Worker, Clinical primary | 1041C0700X | 969-123 (WI) |
| Social Worker, Clinical | 1041C0700X | 149-005163 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.