| Amanda Marie Anhalt, LCSW, CSAC | |
|
2600 Kiley Way, Plymouth, WI 53073-5020 | |
| (920) 459-1494 | |
| Not Available |
| Full Name | Amanda Marie Anhalt |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 19 Years |
| Location | 2600 Kiley Way, Plymouth, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447758693 | NPI | - | NPPES |
| 16200-132 | Other | WI | CLINICAL SUBSTANCE ABUSE COUNSELOR |
| 100075198 | Medicaid | WI | |
| 8860-123 | Other | WI | LICENSED CLINICAL SOCIAL WORKER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 8860-123 (Wisconsin) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 16200-132 (Wisconsin) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Nett Work Family Counseling Llc | 5597849604 | 5 |
| Entity Name | Nett Work Family Counseling Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053406066 PECOS PAC ID: 5597849604 Enrollment ID: O20080228000182 |
| Entity Name | County Of Sheboygan |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477677615 PECOS PAC ID: 2567568918 Enrollment ID: O20080409000126 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Marie Anhalt, LCSW, CSAC Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Amanda Marie Anhalt, LCSW, CSAC 2600 Kiley Way, Plymouth, WI 53073-5020 Ph: (920) 459-1494 |
Laura Roberts, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2209 Eastern Ave, Plymouth, WI 53073 Phone: 920-892-7606 | |
Ms. Rachel M Nelson, LCSW, CSAC Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2600 Kiley Way, Plymouth, WI 53073 Phone: 920-629-0683 |