Amanda Lynn Kubista Owen, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9421-123 Issued in WI

Practice address

800 West Ave S
La Crosse, WI 54601-8806

Phone

(608) 785-0940

NPI assigned

Oct 31, 2024

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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

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.

• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1629056049
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1942980917
  NPD

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1497577217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860912",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860912",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018806",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBISTA OWEN",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9421-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akubista26517@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "800 West Ave S",
            "city": "LA Crosse",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546018806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chelsea M Kruse, MD
• Kathy Ann Kryzenske, RN
• Andrew Krzebietke, PHARMD
• Cassandra Leigh Krzebietke
• Mary Beth Kube, RN
• Kendal R Kuboushek
• Joshua Michal Kucharski, DMD
• Nicole Kuecker, OT
• Joliene K Kues, APRN
• Jessica Lynn Kuester

• Clinical Social Worker in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Clinical Social Worker in Wisconsin

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