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NPI Code Detail

MEDICARE: MS. AMY CLAIRE WILLETTE RN, MS, CADC, LCSW

MEDICARE: MS. AMY CLAIRE WILLETTE RN, MS, CADC, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor12563WI
21041C0700XClinical Social Worker6640-123WI
3163WP0808XPsychiatric/Mental Health Registered Nurse81985-030WI

General Provider Information

NPI Number : 1285687483
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY CLAIRE WILLETTE RN, MS, CADC, LCSW
Provider Business Mailing Address
First Line : 703 ROSE ST
Second Line :
City : BLACK RIVER FALLS
State : WI
Zip : 54615-9201
Country : US
Telephone Number : 715-284-4058
Fax Number :
Provider Business Practice Location Address
First Line : 517 COURT ST
Second Line : ROOM 503
City : NEILLSVILLE
State : WI
Zip : 54456-1971
Country : US
Telephone Number : 715-743-5204
Fax Number : 715-743-5209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 09/11/2025

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