Amy Pickering, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16759 Issued in MN

Practice address

4027 County Road 25
Minneapolis, MN 55416-2629

Phone

(612) 925-6033

Fax

(612) 925-8496

NPI assigned

Jan 16, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Amy Archibald Former name

Medicare fee-for-service enrollment

Enrolled in MN

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD (past)
• LDS Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn Center, MN
  • NPI 1043363567
  NPD (past)

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1154743789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 SHERREN ST W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134408",
            "telephone_number": "651-755-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 COUNTY ROAD 25",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554162629",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "149 Thompson Ave E Ste 150",
            "address_purpose": "LOCATION",
            "city": "West St Paul",
            "state": "MN",
            "postal_code": "551183238",
            "country_code": "US",
            "telephone_number": "651-450-0860",
            "fax_number": "651-450-0759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "985 Sherren St W",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MN",
            "postal_code": "551134408",
            "country_code": "US",
            "telephone_number": "651-755-8218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKERING",
        "first_name": "AMY",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "ARCHIBALD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bryan Piatt
• Amber Piazza, MD
• Michelle R Picconi, NP
• Shannon Pichelman, LICSW
• Aimee Nichole Pickering, CNP
• Kent R Pickrell, CRNA
• Sean Pickthorn
• Taylor John Pickthorn, DDS
• Justine M Pidcock, MD
• David Richard Piechota, M.D.

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.