MEDICARE: AMY BICKNELL 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
1	1041C0700X	Clinical Social Worker	SWI.LW.70039985	WA
2	1041C0700X	Clinical Social Worker
3	1041C0700X	Clinical Social Worker	149.020845	IL

General Provider Information

NPI Number	:	1285241950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY BICKNELL LCSW

Provider Business Mailing Address
First Line	:	3901 FREMONT AVE N APT 207
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-7767
Country	:	US
Telephone Number	:	773-217-0004
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 E ERIE ST STE 525-4963
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2740
Country	:	US
Telephone Number	:	773-217-0004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2020
Last Update Date	:	12/10/2025

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