Amy Lynn Widenbaum, MSW,LMSW,CSW,ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801066237 Issued in MI

Practice address

23800 Orchard Lake Rd Ste 215
Farmington Hills, MI 48336-2562

Phone

(248) 568-9680

Fax

(248) 493-6212

NPI assigned

Jan 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Amy L. Widenbaum, LMSW, PC

  • Clinical Social Worker
  • Farmington Hills, MI
  • NPI 1053578179
  Medicare reassignment Authorized official
• Suhasini S Mistry MD PLC

  • Psychiatry Physician
  • Livonia, MI
  • NPI 1649606724
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1558428276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23800 ORCHARD LAKE RD STE 215",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362562",
            "telephone_number": "248-568-9680",
            "fax_number": "248-493-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23800 ORCHARD LAKE RD STE 215",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362562",
            "telephone_number": "248-568-9680",
            "fax_number": "248-493-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDENBAUM",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MSW,LMSW,CSW,ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801066237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "476528",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "80-0-89-6782-0",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "537109-000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mason Wicking
• Larry A Wickless, M.D.
• Cheyanne Wicks
• Justyce Wicks
• Monet Widemon
• Sarah Widing
• Alan Widlansky, D.O.
• James Widmer
• Mary E Width, MS, RD, FAND
• Lucille Elliot Wiebelt

• Clinical Social Worker in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.