Individual provider Active NPI

Amy A Waddell, LMSW

  • Social Worker
  • Okemos, MI
National Provider Identifier
1528722576
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801073623 Issued in MI
Practice address
2149 Jolly Rd Ste 500
Okemos, MI 48864-6028
Phone
(517) 347-4645
Fax
(517) 347-4644
NPI assigned
Oct 26, 2021
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 6801073623 MI Primary

Addresses

Primary practice location

2149 Jolly Rd Ste 500
Okemos, MI 48864-6028

Mailing address

13401 Norway Pine Dr
Dewitt, MI 48820-9696
Phone (517) 347-4645

Other identifiers 1

IdentifierTypeStateIssuer
6801073623OtherMISTATE OF MICHIGAN

Other names 1

  • Amy Orwig Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@wellnessinstitutemi.com Karen Gallagher LMSW ACSW Professional Counseling Srvs LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20211027001755 MI Practitioner - Clinical Social Worker 3971991738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2149 Jolly Rd
Suite 500
Okemos, MI 48864-6028
Phone (517) 347-4645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Karen Gallagher LMSW Acsw Professional Counseling SRVS LLC Single Specialty CurrentSince Oct 26, 2021 Accepting new patients

Locations

2149 Jolly Rd
Ste 500
Okemos, MI 48864
Phone 5173474645102

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1528722576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13401 NORWAY PINE DR",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488209696",
            "telephone_number": "517-347-4645",
            "fax_number": "517-347-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 JOLLY RD STE 500",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646028",
            "telephone_number": "517-347-4645",
            "fax_number": "517-347-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "AMY",
        "middle_name": "A",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801073623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "6801073623",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@wellnessinstitutemi.com",
            "affiliation": "Y",
            "endpointDescription": "HIPPA compliant secure email",
            "affiliationName": "Karen Gallagher LMSW ACSW Professional Counseling Srvs LLC",
            "address_1": "2149 Jolly Rd Ste 500",
            "city": "Okemos",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488646028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "ORWIG",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.