Active NPI
Amy Lynn Mauel, LCSW
- Clinical Social Worker
- Watertown, WI
National Provider Identifier
1336157809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7200123
- Practice address
- 1315 W Main St
Watertown, WI 53094 - Phone
- (920) 261-4100
- Fax
- (920) 261-8801
- NPI assigned
- Aug 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7200123 | WI | Primary |
Addresses
Primary practice location
1315 W Main St
Watertown, WI 53094
Mailing address
PO Box 364
Watertown, WI 53094-0364
Phone (920) 261-4100
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14164 | Other | DEAN INS | |
| 2016162 | Other | PHYSICIANS PLUS INS | |
| 39184249630 | Other | WI | UNITY INSURANCE WATERTOWN |
| 39184249631 | Other | WI | UNITY INS LAKE MILLS |
| 40995200 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7200123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Resources Associates Inc | Past | Accepting new patients | |
| Family Resources Associates Inc | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Jefferson, WI
- NPI 1497960645
-
- Mental Health Counselor
- Watertown, WI
- NPI 1831202621
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336157809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 364",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530940364",
"telephone_number": "920-261-4100",
"fax_number": "920-261-8801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 W MAIN ST",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "53094",
"telephone_number": "920-261-4100",
"fax_number": "920-261-8801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAUEL",
"first_name": "AMY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "7200123",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN INS",
"identifier": "14164",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIANS PLUS INS",
"identifier": "2016162",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITY INSURANCE WATERTOWN",
"identifier": "39184249630",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITY INS LAKE MILLS",
"identifier": "39184249631",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40995200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Watertown, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.