Gina Amante

Individual provider Active NPI Clinical Social Worker · Wallingford, CT

NPI 1487323747 · NPPES record last updated Aug 6, 2026

Key facts

NPI
1487323747
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
011710 (CT)
Practice address
45 Fair St FL 1
Wallingford, CT 06492-4208
Phone
(203) 414-1059
NPI assigned
Sep 9, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
011710CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wild Empowerment LLC Clinical Current Accepting new patients

Locations

4 Research Dr
Ste 402
Shelton, CT 06484
Phone (203) 293-9300

45 Fair St
#1
Wallingford, CT 06492
Phone (203) 293-3457

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 011710 CT Yes

Addresses

Primary practice location

45 Fair St FL 1
Wallingford, CT 06492-4208

Mailing address

45 Fair St FL 1
Wallingford, CT 06492-4208
Phone (203) 951-1393

Other identifiers

IdentifierTypeStateIssuer
011710OtherCTLICENSE CLINICAL SOCIAL WORKER

Other providers in Wallingford, CT

All providers in Wallingford, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.