Individual provider Active NPI

Amy Louise Heincelman, LMSW

  • Clinical Social Worker
  • Auburn Hills, MI
National Provider Identifier
1972058675
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801062196 Issued in MI
Practice address
2011 Executive Hills Dr
Auburn Hills, MI 48326-2944
Phone
(248) 978-8697
Fax
(248) 282-7372
NPI assigned
Aug 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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 6801062196 MI Primary

Addresses

Primary practice location

2011 Executive Hills Dr
Auburn Hills, MI 48326-2944

Mailing address

2011 Executive Hills Dr
Auburn Hills, MI 48326-2944
Phone (248) 978-8697

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
6801062196MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland County Community Mental Health Authority Past Accepting new patients
Oakland County Community Mental Health Authority Past 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": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1972058675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 EXECUTIVE HILLS DR",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262944",
            "telephone_number": "248-978-8697",
            "fax_number": "248-282-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 EXECUTIVE HILLS DR",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262944",
            "telephone_number": "248-978-8697",
            "fax_number": "248-282-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINCELMAN",
        "first_name": "AMY",
        "middle_name": "LOUISE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801062196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.