Amy Lee Kienow Paychek
Individual provider Active NPI Clinical Social Worker · Riverside, IL
NPI 1376878710 · NPPES record last updated Mar 26, 2025
Key facts
- NPI
- 1376878710
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 149.015345 (IL)
- Practice address
- 338 Lawton Rd
Riverside, IL 60546-2359 - Phone
- (605) 380-0349
- NPI assigned
- Oct 2, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 149.015345 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soul Renewal Therapy LLC | Clinical | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.015345 | IL | Yes |
Addresses
Primary practice location
338 Lawton Rd
Riverside, IL 60546-2359
Mailing address
338 Lawton Rd
Riverside, IL 60546-2359
Phone (605) 380-0349
Other providers in Riverside, IL
- Ernest Kaminski
- Jennifer Kang
- Deepika Karki
- Nithya Karpagavinayagam
- Nicole Kasperek
- Martin Peter Kornak
- Deborah J. Krause
- Diana Alexandra Kreppel
- Catherine J Kruse
- Todd Michael Kubon
All providers in Riverside, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2025. 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.