Individual provider Active NPI

Amber Mariah Reynolds, LMSW

  • Social Worker
  • Hillsdale, MI
National Provider Identifier
1053880179
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801114441 Issued in MI
Practice address
76 W Lynwood Blvd
Hillsdale, MI 49242-1962
Phone
(517) 320-3241
NPI assigned
Nov 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6801098915 MI
Social Worker 104100000X 6801114441 MI Primary

Addresses

Primary practice location

76 W Lynwood Blvd
Hillsdale, MI 49242-1962

Mailing address

76 W Lynwood Blvd
Hillsdale, MI 49242-1962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220802001997 MI Practitioner - Clinical Social Worker 9931581352 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801098915MIMDMental Health Counselor
6801114441MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amber Reynolds LMSW PLLC Social Worker CurrentSince Dec 14, 2022 Accepting new patients

Locations

569 Wildwood Ave
Unit 4
Jackson, MI 49201
Phone (517) 788-6404

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1053880179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 W LYNWOOD BLVD",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492421962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 W LYNWOOD BLVD",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492421962",
            "telephone_number": "517-320-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "AMBER",
        "middle_name": "MARIAH",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801098915",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801114441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsdale, MI

Sources for this page

Verify at the official NPI Registry.