Individual provider Active NPI

Amy Marzulla, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1043640295
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092297 Issued in MI
Practice address
238 Nickels Arc
Ann Arbor, MI 48104-2410
Phone
(734) 210-0971
NPI assigned
Nov 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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 6801092297 MI Primary

Addresses

Primary practice location

238 Nickels Arc
Ann Arbor, MI 48104-2410

Mailing address

PO Box 2257
Chesterton, IN 46304-0357
Phone (219) 926-8320

Other practice location 1

2082 S State St
Ann Arbor, MI 48104-4608
Phone (734) 210-0971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220127000973 MI Practitioner - Clinical Social Worker 8628460524 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801092297MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cycle Breakers Collective LLC Clinical CurrentSince Oct 7, 2025 Accepting new patients

Locations

2082 S State St
Ann Arbor, MI 48104
Phone (734) 210-0150

238 Nickels Arc
Ann Arbor, MI 48104
Phone (734) 210-0971

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1385251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1043640295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357",
            "telephone_number": "219-926-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 NICKELS ARC",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042410",
            "telephone_number": "734-210-0971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2082 S STATE ST",
            "address_purpose": "LOCATION",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044608",
            "country_code": "US",
            "telephone_number": "734-210-0971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARZULLA",
        "first_name": "AMY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-24",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.