Amy Jacquelin Petrulis, M.S., L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1060 Issued in MT

Practice address

108 1/2 W Callender St Apt 4
Livingston, MT 59047-2647

Phone

(406) 223-2092

Fax

(406) 823-6305

NPI assigned

Jan 24, 2012

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 MT

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1194096016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W FRONT ST",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590471925",
            "telephone_number": "406-223-2092",
            "fax_number": "406-823-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 1/2 W CALLENDER ST APT 4",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590472647",
            "telephone_number": "406-223-2092",
            "fax_number": "406-823-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRULIS",
        "first_name": "AMY",
        "middle_name": "JACQUELIN",
        "name_prefix": "Ms.",
        "credential": "M.S., L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "1060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park County Special Education Cooperative
• Park Health Care PLLC
• Partnership for Health & Wellness, Inc.
• Shawn Glenn Patrick, PHARM D
• PCRS 360 Dba Rural Resilience
• Chad Petrulis, MSW, LCSW
• Caroline Lamar Pihl, MD
• Henry Pinango, MD
• Kyra E Pinango, M.D.
• Lindsey Pippin, MBA, LBA

• Clinical Social Worker in Livingston, MT
• Providers in Livingston, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.
• 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.