Individual provider Active NPI

Amber Lynn Wogomon, LMSW, LMAC

  • Clinical Social Worker
  • Concordia, KS
National Provider Identifier
1205443520
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11772 Issued in KS
Practice address
209 W 6TH St
Concordia, KS 66901-2816
Phone
(785) 560-3101
Fax
(785) 527-8317
NPI assigned
Sep 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 00894 KS
Clinical Social Worker 1041C0700X 11772 KS Primary

Addresses

Primary practice location

209 W 6TH St
Concordia, KS 66901-2816

Mailing address

1329 18TH St
Belleville, KS 66935-2209
Phone (785) 527-8271

Other names 1

  • Amber Lynn Meczwyor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00894KSMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Courser Lapo Inc Addiction (Substance Use Disorder) CurrentSince Oct 4, 2020 Accepting new patients
Rest Cure Wellness, LLC Clinical CurrentSince Dec 29, 2024 Accepting new patients

Locations

1329 18th St
Belleville, KS 66935
Phone (785) 560-3101

209 W 6th St
Concordia, KS 66901
Phone (785) 560-3101

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1205443520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 18TH ST",
            "city": "BELLEVILLE",
            "state": "KS",
            "postal_code": "669352209",
            "telephone_number": "785-527-8271",
            "fax_number": "785-527-8317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W 6TH ST",
            "city": "CONCORDIA",
            "state": "KS",
            "postal_code": "669012816",
            "telephone_number": "785-560-3101",
            "fax_number": "785-527-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOGOMON",
        "first_name": "AMBER",
        "middle_name": "LYNN",
        "credential": "LMSW, LMAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "00894",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "11772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "MECZWYOR",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concordia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.