Individual provider Active NPI

Amanda C Romero, LCSW

  • Clinical Social Worker
  • Williams Bay, WI
National Provider Identifier
1003623000
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12057-123 Issued in WI
Practice address
93 W Geneva St
Williams Bay, WI 53191-9566
Phone
(262) 607-6390
NPI assigned
Dec 12, 2024
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12057-123 WI Primary

Addresses

Primary practice location

93 W Geneva St
Williams Bay, WI 53191-9566

Mailing address

PO Box 934
Williams Bay, WI 53191-0934
Phone (262) 607-6390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250213002609 WI Practitioner - Clinical Social Worker 5193255503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
C.a. Counseling and Consultants, LLCGroup PAC ID 9032424486, 3 clinicians

Practice addresses (Care Compare)

93 W Geneva St
Williams Bay, WI 53191-9566
Phone (262) 607-6390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
C.a. Counseling & Consultants, LLC. Clinical CurrentSince Feb 6, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1003623000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 934",
            "city": "WILLIAMS BAY",
            "state": "WI",
            "postal_code": "531910934",
            "telephone_number": "262-607-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 W GENEVA ST",
            "city": "WILLIAMS BAY",
            "state": "WI",
            "postal_code": "531919566",
            "telephone_number": "262-607-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "AMANDA",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12057-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williams Bay, WI

Sources for this page

Verify at the official NPI Registry.