Individual provider Active NPI

Amy Lynn Mauel, LCSW

  • Clinical Social Worker
  • Watertown, WI
National Provider Identifier
1336157809
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7200123 Issued in WI
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

Updated by the provider on Jul 8, 2007

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 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

IdentifierTypeStateIssuer
14164OtherDEAN INS
2016162OtherPHYSICIANS PLUS INS
39184249630OtherWIUNITY INSURANCE WATERTOWN
39184249631OtherWIUNITY INS LAKE MILLS
40995200MedicaidWI

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
7200123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Resources Associates Inc Past Accepting new patients
Family Resources Associates Inc PastSince Jun 23, 2004 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.

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.

Verify at the official NPI Registry.