Healthcare Provider Details

I. General information

NPI: 1437449881
Provider Name (Legal Business Name): AMANDA LYNN GALE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA LYNN WETZ LCSW

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2871 BELGARDE BLVD APT 305
RAPID CITY SD
57702-9818
US

IV. Provider business mailing address

2360 E PERSHING BLVD
CHEYENNE WY
82001-5356
US

V. Phone/Fax

Practice location:
  • Phone: 605-645-0423
  • Fax:
Mailing address:
  • Phone: 307-778-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6073
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number854
License Number StateWY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: