Amy Wickliffe, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6170-C Issued in AR

Practice address

685 Shelby TRL Ste 105
Conway, AR 72034-7169

Phone

(501) 410-0092

NPI assigned

Mar 29, 2010

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  AR

  Medicare reassignment NPD
• Thriveworks Telepsychiatry - Arkansas

  • Mental Health Counselor
  • Fayetteville, AR
  • NPI 1669130928
  NPD

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1417272923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414",
            "city": "GREENBRIER",
            "state": "AR",
            "postal_code": "720580414",
            "telephone_number": "501-679-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 SHELBY TRL STE 105",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347169",
            "telephone_number": "501-410-0092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575A Harkrider St",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720325631",
            "country_code": "US",
            "telephone_number": "501-679-0232",
            "fax_number": "833-373-0348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 S Broadview St Ste E&f",
            "address_purpose": "LOCATION",
            "city": "Greenbrier",
            "state": "AR",
            "postal_code": "720589601",
            "country_code": "US",
            "telephone_number": "501-679-0232",
            "fax_number": "833-373-0348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKLIFFE",
        "first_name": "AMY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "2394-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6170-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lee White, AUD
• Tyjuan White
• Emma Whiteaker, LPC
• Ashton Taylor Whiting, APRN
• Catlin Faye Whitlow
• Bobie Jo Widders, MD
• Richard L Wiedower, DDS
• Micah David Wiegel, M.D.
• Shelly Beth Wier, CCC-SLP
• Kassie Wiest, DC, ATC

• Clinical Social Worker in Conway, AR
• Providers in Conway, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.