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NPI · 1104241066 · NPPES-sourced

Amy Mack Licsw

ActiveClinical Social Worker
NPI Number
1104241066
Type 1 · Individual
Taxonomy Code
1041C0700X
Contact
(315) 897-5699
License NY · 090752
Last Updated
About 3 months ago (Mar 2026)
Enumerated 2014-02-28
Primary practice addressNY · 13039-8652
5708 S Bay RdCicero, NY 13039-8652
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Also known as

  • Formerly known asVandusen, Amy

Source: NPPES public registry.

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About this NPIWhat this record shows.

NPI 1104241066 is registered to Amy Mack Licsw, a Clinical Social Worker practising at 5708 S Bay Rd in Cicero, New York. Clinical Social Worker is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy. Amy Mack Licsw has been enumerated in the National Provider Identifier (NPI) registry since 2014.

Provider type
Individual (Type 1)
Status
Active
Enumerated
2014-02-28
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Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Amy Mack Licsw accepts. To confirm in-network status with your specific health plan, contact Amy Mack Licsw directly at (315) 897-5699.

Frequently asked

Yes. NPI 1104241066 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Clinical Social Worker is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (315) 897-5699.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Amy Mack Licsw is a Type-1 individual NPI.

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Quick facts

Provider typeIndividual
Taxonomy1041C0700X
Last updated2026-03
Enumerated2014-02-28
StatusActive
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