Individual provider Active NPI

Amy Ryan-Heiser, LCSW-R

  • Clinical Social Worker
  • Williamsville, NY
National Provider Identifier
1497809404
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
070379 1 Issued in NY
Practice address
2805 Wehrle Dr Ste 1
Williamsville, NY 14221-7383
Phone
(716) 908-9363
Fax
(716) 633-1280
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 070379 1 NY Primary

Addresses

Primary practice location

2805 Wehrle Dr Ste 1
Williamsville, NY 14221-7383

Mailing address

2805 Wehrle Dr Ste 1
Williamsville, NY 14221-7383
Phone (716) 908-9363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20171227000923 NY Order and Referring Only - Clinical Social Worker 2264790096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070379 1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Adolescent Treatment Service Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1497809404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 WEHRLE DR STE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217383",
            "telephone_number": "716-908-9363",
            "fax_number": "716-633-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 WEHRLE DR STE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217383",
            "telephone_number": "716-908-9363",
            "fax_number": "716-633-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN-HEISER",
        "first_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070379 1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.