Amanda Henke, APSW

Key facts

NPI

1801622352

Entity type

Individual (NPI type 1)

Primary specialty

Social Worker 104100000X

License

135130 (WI)

Practice address

811 Harding St
Waupaca, WI 54981-2012

Phone

(715) 281-8293

NPI assigned

Sep 11, 2024

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

Other names

• Amanda Moran Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 11, 2024.

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1801622352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 HARDING ST",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549812012",
            "telephone_number": "715-281-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 HARDING ST",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549812012",
            "telephone_number": "715-281-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKE",
        "first_name": "AMANDA",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "135130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MORAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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