Individual provider Active NPI

Amanda Mary Ruechel, MSW, LCSW

  • Clinical Social Worker
  • Union Grove, WI
National Provider Identifier
1730846692
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11695-123 Issued in WI
Practice address
4380 67TH Dr # 1043
Union Grove, WI 53182-9338
Phone
(920) 588-8146
NPI assigned
Nov 25, 2021
Last updated
Dec 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11695-123 WI Primary

Addresses

Primary practice location

4380 67TH Dr # 1043
Union Grove, WI 53182-9338

Mailing address

4380 67TH Dr # 1043
Union Grove, WI 53182-9338
Phone (920) 588-8146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 18, 2024 through Apr 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11695-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Reflections Mental Health LLC PastSince Nov 1, 2021 Accepting new patients

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": "1637798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1730846692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 67TH DR # 1043",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531829338",
            "telephone_number": "920-588-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 67TH DR # 1043",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531829338",
            "telephone_number": "920-588-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUECHEL",
        "first_name": "AMANDA",
        "middle_name": "MARY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-25",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11695-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union Grove, WI

Sources for this page

Verify at the official NPI Registry.