Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amanda Marie Derewicz, LCSW

Individual provider Clinical Social Worker · NPI 1366261695

Amanda Marie Derewicz, LCSW is a Clinical Social Worker in Greenfield, Wisconsin. Qualified in 2020, 6 years ago. Practices with Nystrom and Associates Counseling Wi SC, a 114-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2024
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

4131 W Loomis Rd Apt 120
Greenfield, WI 53221-2006
Phone: (414) 424-2445
Fax: (414) 424-2446
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 11512-123 (WI)

Record details

NPI number1366261695
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedOctober 3, 2024
Last updated in NPPESOctober 10, 2024
Certification dateOctober 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Nystrom And Associates Counseling Wi Sc — 114 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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