Amy Wilder, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078001 Issued in NY

Practice address

330 W 85TH St
Apt. 4E
New York, NY 10024-3803

Phone

(347) 746-1338

NPI assigned

Feb 1, 2010

Last updated

Jan 5, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 12, 2018 through Feb 12, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1689906612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 85TH ST APT 4E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243814",
            "telephone_number": "917-364-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 85TH ST",
            "address_2": "APT. 4E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243803",
            "telephone_number": "347-746-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "AMY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wildcat Service Corporation
• Annabelle Michela Wilde, P.T.
• Gregory Wilde
• Meredith Wilde
• Lisa Ann Wildenberger, MSSPED
• Maya A. Wilder, MLIS, MS, LMHC, NCC
• Melvyn Wilder Jr., CASAC
• Brooke T Wildes
• Wildflower Telehealth Network Inc.
• Melody Wilding, LMSW

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.