Amy L Schrupp, CSW-PIP, LAC
Individual provider Active NPI Clinical Social Worker · Ellsworth Afb, SD
NPI 1285056366 · NPPES record last updated Apr 8, 2022
Key facts
- NPI
- 1285056366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6076 (SD)
- Practice address
- 2900 Doolittle Dr BLDG 6000
Ellsworth Afb, SD 57706-4821 - Phone
- (605) 385-3656
- Fax
- (605) 385-2030
- NPI assigned
- Jan 9, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13031561 | SD | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior Management Systems, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 13031561 | SD | |
| Clinical Social Worker | 1041C0700X | 6076 | SD | Yes |
Addresses
Primary practice location
2900 Doolittle Dr BLDG 6000
Ellsworth Afb, SD 57706-4821
Mailing address
2900 Doolittle Dr BLDG 6000
Ellsworth Afb, SD 57706-4821
Phone (605) 385-3656
Other practice location 1
350 Elk St
Rapid City, SD 57701
Phone (605) 343-7262
Other practice location 2
123 19th St NE
Watertown, SD 57201-2823
Phone (605) 886-0123
Other names
- Amy Lynn Cantral
Other providers in Ellsworth Afb, SD
- Jesse C Roberts
- Christopher Scott Rohde
- Heather Ann Rystrom
- Carol Rose Sasse
- Blake Carroll Savage
- Kiersten Severino
- Kimberly Ann Shea
- Joshua Shumway
- Betty Mae Smith
- Rachel Theresa Smith
All providers in Ellsworth Afb, SD · Clinical Social Worker in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.