Individual provider Active NPI

Kimberly R Amador, MSW PCSW

  • Clinical Social Worker
  • Casper, WY
National Provider Identifier
1295299253
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PCSW-779 Issued in WY
Practice address
1840 Lakota TRL
Casper, WY 82601-7701
Phone
(307) 351-0863
NPI assigned
Jan 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PCSW-779 WY Primary

Addresses

Primary practice location

1840 Lakota TRL
Casper, WY 82601-7701

Mailing address

1840 Lakota TRL
Casper, WY 82601-7701
Phone (307) 351-0863

Other practice location 1

915 S McKinley St
Casper, WY 82601-3440
Phone (307) 351-0863

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
PCSW-779WYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1295299253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 LAKOTA TRL",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826017701",
            "telephone_number": "307-351-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 LAKOTA TRL",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826017701",
            "telephone_number": "307-351-0863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 S McKinley St",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "826013440",
            "country_code": "US",
            "telephone_number": "307-351-0863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMADOR",
        "first_name": "KIMBERLY",
        "middle_name": "R",
        "credential": "MSW PCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "PCSW-779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.