Individual provider Active NPI

Amanda Zalokar, LCSW

  • Clinical Social Worker
  • Racine, WI
National Provider Identifier
1255877148
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9292-123 Issued in WI
Practice address
1333 College Ave
Racine, WI 53403-1920
Phone
(262) 687-4011
NPI assigned
Jan 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17909-130 WI
Social Worker 104100000X 130498-121 WI
Clinical Social Worker 1041C0700X 9292-123 WI Primary

Addresses

Primary practice location

1333 College Ave
Racine, WI 53403-1920

Mailing address

4211 Danbury LN
Mount Pleasant, WI 53403-4020
Phone (262) 914-0720

Other practice location 1

6321 23rd Ave
Kenosha, WI 53143-4801
Phone (414) 455-3879 ext. 828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17909-130WIMDAddiction (Substance Use Disorder) Counselor
130498-121WIMDSocial Worker
9292-123WIMDClinical Social Worker
9292WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Services Group, Inc. Addiction (Substance Use Disorder) CurrentSince Apr 1, 2021 Accepting new patients
Amri Counseling Services, LLC PastSince Sep 10, 2018 Accepting new patients

Locations

6233 39th Ave
Kenosha, WI 53142
Phone (262) 654-1004

2108 63rd St
Kenosha, WI 53143

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1255877148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 DANBURY LN",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534034020",
            "telephone_number": "262-914-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 COLLEGE AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031920",
            "telephone_number": "262-687-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6321 23rd Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531434801",
            "country_code": "US",
            "telephone_number": "414-455-3879 x828",
            "fax_number": "866-719-3024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZALOKAR",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-16",
        "last_updated": "2021-04-08",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17909-130",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "130498-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9292-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.