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

Individual provider Clinical Social Worker · NPI 1457946915

Amanda Rae Vantilburg, LCSW is a Clinical Social Worker in Colorado Springs, Colorado. Qualified in 2017, 9 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Hawaii.

Years since qualifying
9
Licensed in
HI
In the registry since
2021
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

878 Altamont Ridge Dr
Colorado Springs, CO 80921-8414
Phone: (254) 394-4908
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 91-960 Iwikuamoo St Unit 305, Ewa Beach, HI 96706-4890 — (254) 394-4908

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-4518 (HI)

Record details

NPI number1457946915
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMarch 6, 2021
Last updated in NPPESMay 7, 2022
Certification dateMay 7, 2022

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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