Individual provider Active NPI

Amber N Elvert, CSAC

  • Addiction (Substance Use Disorder) Counselor
  • Oshkosh, WI
National Provider Identifier
1679934442
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
16466 Issued in WI
Practice address
220 Washington Ave
Oshkosh, WI 54901-5030
Phone
(920) 236-4700
Fax
(920) 236-1157
NPI assigned
Mar 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16010-131 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 16466 WI Primary

Addresses

Primary practice location

220 Washington Ave
Oshkosh, WI 54901-5030

Mailing address

220 Washington Ave
Oshkosh, WI 54901-5030
Phone (920) 236-4700

Other names 1

  • Amber N Hickman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16010-131WIMDAddiction (Substance Use Disorder) Counselor
16466WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Winnebago County Past Accepting new patients
County of Winnebago PastSince Dec 1, 2003 Accepting new patients

Organizations & group practices 2

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": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1679934442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 WASHINGTON AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549015030",
            "telephone_number": "920-236-4700",
            "fax_number": "920-236-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 WASHINGTON AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549015030",
            "telephone_number": "920-236-4700",
            "fax_number": "920-236-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELVERT",
        "first_name": "AMBER",
        "middle_name": "N",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16010-131",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "HICKMAN",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.