Individual provider Active NPI

Ambre Lei Witte, LCSW

  • Clinical Social Worker
  • Lancaster, PA
National Provider Identifier
1982049904
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW020276 Issued in PA
Practice address
205 Granite Run Dr
Suite 310
Lancaster, PA 17601-6821
Phone
(717) 617-2065
Fax
(717) 824-4862
NPI assigned
May 3, 2013
Last updated
Jan 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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 CW020276 PA Primary

Addresses

Primary practice location

205 Granite Run Dr
Suite 310
Lancaster, PA 17601-6821

Mailing address

205 Granite Run Dr
Suite 310
Lancaster, PA 17601-6821
Phone (717) 617-2065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190131003128 PA Practitioner - Clinical Social Worker 2365789112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

205 Granite Run Dr
Suite 310
Lancaster, PA 17601-6821
Phone (717) 617-2065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW020276PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life and Love Counseling LLC CurrentSince Dec 18, 2018 Accepting new patients

Locations

205 Granite Run Dr
Ste 310
Lancaster, PA 17601
Phone (717) 617-2065

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": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1982049904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 GRANITE RUN DR",
            "address_2": "SUITE 310",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016821",
            "telephone_number": "717-617-2065",
            "fax_number": "717-824-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 GRANITE RUN DR",
            "address_2": "SUITE 310",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016821",
            "telephone_number": "717-617-2065",
            "fax_number": "717-824-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTE",
        "first_name": "AMBRE",
        "middle_name": "LEI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.