Amanda Jane Wissler, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5869457-3501 Issued in UT

Practice address

2078 Prospector Ave Ste 1
Park City, UT 84060-7587

Phone

(801) 448-8264

NPI assigned

Sep 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Amanda Wissler Counseling, PLLC

  • Social Worker
  • Park City, UT
  • NPI 1497491559
  NPD Authorized official

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1417326687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6749 N 2200 W APT B103",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840988305",
            "telephone_number": "801-448-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2078 PROSPECTOR AVE STE 1",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607587",
            "telephone_number": "801-448-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSLER",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "5869457-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Mallory Fadal Wilson, M.D.
• Katherine Wilson
• Michelle Hill Wilson, MD
• Patricia K Winkelman, D.C.
• Robert T Winn, M.D.
• Kenneth Alan Wolkoff, M.D.
• Kary Ellen Woodruff, R.D., M.S., C.D.
• Kelly H Woodward I, D.O., M.P.H.
• Cade Benjamin Woolsey
• Courtney N. Woolsey, RD

• Clinical Social Worker in Park City, UT
• Providers in Park City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.