Amy Wieboldt, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2025050005 Issued in MO

Practice address

1579 NE Rice Rd
Lees Summit, MO 64086-5849

Phone

(816) 966-0900

Fax

(816) 347-3200

NPI assigned

May 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Rediscover

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lees Summit, MO
  • NPI 1841235298
  Medicare reassignment NPD
• Rediscover

  • Methadone Clinic
  • Kansas City, MO
  • NPI 1659749414
  NPD

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1043067010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NE RICE RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865849",
            "telephone_number": "816-966-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1579 NE RICE RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865849",
            "telephone_number": "816-966-0900",
            "fax_number": "816-347-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEBOLDT",
        "first_name": "AMY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2023042126",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2025050005",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2023042126",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiersten Marie White
• Whiting & Associates, LLC
• Jerri Lynn Whiting, PH.D.
• Sean Whitmore
• Dane K Wicks, MD
• Tyann Wiederholt
• Janna Wiele, MSW, LCSW
• Samantha Wiemann
• Patricia A Wike, P.T.
• Gabrielle Wilcox

• Clinical Social Worker in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.