Amy L. Widenbaum, LMSW, PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801066237 Issued in MI

Legal business name

AMY L. WIDENBAUM, LMSW, PC

Practice address

23800 Orchard Lake Rd Ste 215
Farmington Hills, MI 48336-2562

Phone

(248) 568-9680

Fax

(248) 493-6212

NPI assigned

May 16, 2008

Organization subpart

No

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

Authorized official

Name

Amy Lynn Widenbaum, LMSWNPI 1558428276

Title

Social Worker

Phone

(248) 568-9680

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy Lynn Widenbaum, MSW,LMSW,CSW,ACSW

  • Clinical Social Worker
  • Farmington Hills, MI
  • NPI 1558428276
  Medicare reassignment Authorized official
• Suhasini S Mistry, M.D.

  • Psychiatry Physician
  • Livonia, MI
  • NPI 1609831825
  NPD (past)

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1053578179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23800 ORCHARD LAKE RD STE 215",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362562",
            "telephone_number": "248-568-9680",
            "fax_number": "248-493-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23800 ORCHARD LAKE RD STE 215",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362562",
            "telephone_number": "248-568-9680",
            "fax_number": "248-493-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY L. WIDENBAUM, LMSW, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "WIDENBAUM",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "248-568-9680",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801066237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Schenera Ampey
• Ama Ampomah
• Jerimiah Amundsen
• Tyler Amundson
• Amy K Pruneau LLC
• Amy Zelidman, PLLC
• Zachary Amy
• Jacqueline Anaele
• Nicole Anash
• Carlos Anavisca

• Clinical Social Worker in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.