Individual provider Active NPI

Samantha Leigh Amick, PLMHP, PCMSW

  • Clinical Social Worker
  • Grand Island, NE
National Provider Identifier
1336872878
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
215 N Wheeler Ave
Grand Island, NE 68801-5961
Phone
(308) 391-2280
NPI assigned
Jul 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 Primary

Addresses

Primary practice location

215 N Wheeler Ave
Grand Island, NE 68801-5961

Mailing address

215 N Wheeler Ave
Grand Island, NE 68801-5961
Phone (308) 391-2280

Other practice location 1

8031 W Center Rd
Omaha, NE 68124-3158
Phone (308) 550-0930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250327001136 NE Practitioner - Mental Health Counselor 6305369687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1310 16TH Ave
Suite 1
Central City, NE 68826-2108
Phone (308) 550-3413

2215 Berryman LN
Central City, NE 68826-2108
Phone (308) 550-3413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3746NEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pulse Health & Wellness LLC Clinical CurrentSince Feb 27, 2025 Accepting new patients
Revive Behavioral Health and Wellness LLC Clinical CurrentSince Apr 9, 2024 Accepting new patients

Locations

215 N Wheeler Ave
Grand Island, NE 68801
Phone (308) 391-2280

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1336872878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N WHEELER AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688015961",
            "telephone_number": "308-391-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N WHEELER AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688015961",
            "telephone_number": "308-391-2280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8031 W Center Rd",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681243158",
            "country_code": "US",
            "telephone_number": "308-550-0930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMICK",
        "first_name": "SAMANTHA",
        "middle_name": "LEIGH",
        "credential": "PLMHP, PCMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.