Individual provider Active NPI

Amy Ann Waldbillig, LCSW, PH.D.

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1174005128
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011712 Issued in NC
Practice address
4706 Oleander Dr
Wilmington, NC 28403-5107
Phone
(540) 538-2625
NPI assigned
Sep 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X C011712 NC Primary

Addresses

Primary practice location

4706 Oleander Dr
Wilmington, NC 28403-5107

Mailing address

4706 Oleander Dr
Wilmington, NC 28403-5107
Phone (540) 903-1756

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181206003439 NC Practitioner - Clinical Social Worker 5496099103 Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1174005128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4706 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035107",
            "telephone_number": "540-903-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4706 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035107",
            "telephone_number": "540-538-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDBILLIG",
        "first_name": "AMY",
        "middle_name": "ANN",
        "credential": "LCSW, PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.