Individual provider Active NPI

Amanda Fisher, LCSW

  • Clinical Social Worker
  • Decatur, IL
National Provider Identifier
1942053616
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149027004 Issued in IL
Practice address
2580 E Federal Dr Ste 403
Decatur, IL 62526-2189
Phone
(217) 422-0027
NPI assigned
Apr 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 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 149027004 IL Primary

Addresses

Primary practice location

2580 E Federal Dr Ste 403
Decatur, IL 62526-2189

Mailing address

2580 E Federal Dr Ste 403
Decatur, IL 62526-2189
Phone (217) 422-0027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240725002520 IL Practitioner - Clinical Social Worker 5092251025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decatur Psychiatry LTDGroup PAC ID 8426065186, 4 clinicians

Practice addresses (Care Compare)

2580 E Federal Dr
Suite 403
Decatur, IL 62526-2189
Phone (217) 809-0429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149027004ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Psychiatry LTD CurrentSince May 13, 2024 Accepting new patients
Blooming Minds Counseling PLLC Clinical CurrentSince Apr 1, 2026 Accepting new patients

Locations

363 S Main St
Ste 240
Decatur, IL 62523
Phone (217) 809-0429

3767 E US Route 36
Decatur, IL 62521
Phone (217) 330-6153

2580 E Federal Dr
Ste 403
Decatur, IL 62526
Phone (217) 422-0027

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": "1712707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1942053616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 E FEDERAL DR STE 403",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262189",
            "telephone_number": "217-422-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 E FEDERAL DR STE 403",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262189",
            "telephone_number": "217-422-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-10",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.