Amy Marie Riecken, MSW LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P013519 Issued in NC

Practice address

311 Williamson Rd Ste 103
Mooresville, NC 28117-5967

Phone

(704) 360-3049

NPI assigned

May 31, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

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.

• Bayside Counseling and Wellness PLLC

  • Clinical Social Worker
  • Hampstead, NC
  • NPI 1770309148
  Medicare reassignment NPD Authorized official
• Thrive Counseling and Wellness, PLLC

  • Mental Health Counselor
  • Mooresville, NC
  • NPI 1871003269

  Clinical

  NPD (past)

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1114585593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 EDGEWOOD AVE NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253353",
            "telephone_number": "980-258-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 WILLIAMSON RD STE 103",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175967",
            "telephone_number": "704-360-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIECKEN",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "MSW LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Richendollar, MSW, LCSW
• Taylor Ricketts, RN, IBCLC
• Lina Sihamath Ricks, PA-C
• Susan Spell Ricks, MSP, CCC-SLP
• Meghan Riddle Hunter
• Kelly Cruse Rife, LCMHC
• Michael Ernest Rife, M.ED., LCAS, LPC
• Laura Riley, RDN
• Mary Grace Courtney Riley, CCC-SLP
• Mikayla Ann Rimmer, MSN, APRN, FNP-C

• Clinical Social Worker in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.