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AMY WIEBOLDT LCSW
NPI 1043067010
Social Worker - Clinical in Lees Summit, MO

Active since May 06, 2024PECOS Enrolled
1579 NE RICE RD, LEES SUMMIT, MO 64086(816) 966-0900(816) 347-3200 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 21, 2025, May 14, 2024, May 6, 2024 (3 updates tracked since 2024).

About Amy Wieboldt Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMY WIEBOLDT LCSW (NPI 1043067010) is an individual clinical provider in Lees Summit, Missouri, licensed in Missouri (2025050005) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1043067010
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameAMY WIEBOLDTCredential: LCSW
Location Address1579 NE RICE RDLees Summit, MO 64086-5849
Mailing Address1555 Ne Rice RdLees Summit, MO 64086-5849 · (816) 966-0900
Phone(816) 966-0900
Fax(816) 347-3200
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateMay 6, 2024
Last NPPES UpdateNovember 21, 20253 updates tracked since enumeration
NPPES CertifiedNovember 21, 2025
✔ NPI 1043067010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in MO · 2025050005✔ Licensed in MO · 2023042126
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedSocial WorkerTaxonomy 104100000X · License 2023042126 (MO)
1579 NE RICE RD, Lees Summit, MO 64086
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amy Wieboldt Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173017597
PECOS Enrollment IDI20251212002859
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64086 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $55.29 – $168.52
Typical copayment $0.00 (range $13.82 – $42.13)
Most-billed visit code NA
Established Patient
$69.10 typical visit price
range $17.60 – $137.20
Typical copayment $17.27 (range $4.40 – $34.30)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUNDAY SUE PLATT LPC
Counselor (Professional)
1579 NE RICE RD
LEE'S SUMMIT, MO 64086
Jackson County (816) 966-0900
ELISE NICOLE MARSHALL LMSW
Social Worker
1579 NE RICE RD
LEES SUMMIT, MO 64086
Jackson County (816) 966-0900
FLORA BLAND-WASHINGTON LMSW
Social Worker
1579 NE RICE RD
LEE'S SUMMIT, MO 64086
Jackson County (816) 682-1473
KELSEY EVELYN BRINKMAN
Social Worker
1579 NE RICE RD
LEE SUMMIT, MO 64086
Jackson County (816) 966-0900
LISA MARIE TRACY LPC
Counselor (Professional)
1579 NE RICE RD
LEES SUMMIT, MO 64086
Jackson County (816) 347-3003
MAGGIE RANDALL PLPC
Counselor (Professional)
1579 NE RICE RD
LEES SUMMIT, MO 64086
Jackson County (816) 966-0900
CARINA RACHEL CASTILLEJA RN, MSN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1579 NE RICE RD
LEES SUMMIT, MO 64086
Jackson County (816) 267-3971
MRS. BAYLEE MARIE GOODERL M.S., LPC
Counselor (Professional)
1579 NE RICE RD, BLD. A
LEES SUMMIT, MO 64086
Jackson County (816) 581-5854

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amy Wieboldt's NPI number?

The NPI number for Amy Wieboldt is 1043067010. It was assigned to this individual provider in the NPPES registry on May 6, 2024.

Where is Amy Wieboldt located?

Amy Wieboldt practices at 1579 NE Rice Rd, Lees Summit, MO 64086. The listed phone number is (816) 966-0900.

What is Amy Wieboldt's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Amy Wieboldt enrolled in Medicare?

Yes. Amy Wieboldt is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Amy Wieboldt was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.