Individual provider Active NPI

Amanda Rose Wentz

  • Clinical Social Worker
  • Winston Salem, NC
National Provider Identifier
1629444229
Registry record updated Mar 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011440 Issued in NC
Practice address
175 Kimel Park Dr Ste 100
Winston Salem, NC 27103
Phone
(336) 718-3550
Fax
(336) 277-6981
NPI assigned
Aug 18, 2015
Last updated
Mar 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33007056A IN
Clinical Social Worker 1041C0700X 67544 TX
Clinical Social Worker 1041C0700X C011440 NC Primary

Addresses

Primary practice location

175 Kimel Park Dr Ste 100
Winston Salem, NC 27103

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 718-3550

Other practice location 1

610 Main St
Lafayette, IN 47901-1451
Phone (765) 428-2201

Other practice location 2

610 Main St
Lafayette, IN 47901-1451
Phone (765) 428-2201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190117001395 NC Practitioner - Clinical Social Worker 3274879960 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33007056AINMDSocial Worker
C011440NCMDClinical Social Worker
67544TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Behavioral Medicine PC CurrentSince Nov 20, 2025 Accepting new patients

Locations

445 Dolley Madison Rd
Ste 100
Greensboro, NC 27410
Phone (336) 649-9000

370 Knollwood St
Ste 301
Winston Salem, NC 27103
Phone (336) 252-4440

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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773532800000",
    "number": "1629444229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 KIMEL PARK DR STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-6981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 Main St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479011451",
            "country_code": "US",
            "telephone_number": "765-428-2201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 Main St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479011451",
            "country_code": "US",
            "telephone_number": "765-428-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENTZ",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2026-03-15",
        "certification_date": "2026-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33007056A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "67544",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.