Individual provider Active NPI

Amelia Mariah Simmons, LMSW

  • Social Worker
  • Southgate, MI
National Provider Identifier
1083269922
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801114871 Issued in MI
Practice address
12421 First Ave S
Southgate, MI 48195-3541
Phone
(313) 694-5412
NPI assigned
Aug 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801114871 MI Primary

Addresses

Primary practice location

12421 First Ave S
Southgate, MI 48195-3541

Mailing address

13511 Archdale St
Detroit, MI 48227-1335
Phone (313) 694-5412

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
I20250613003188 MI Practitioner - Clinical Social Worker 6406367739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

1 Heritage Dr
Suite 520
Southgate, MI 48195-3051
Phone (800) 693-1916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801114871MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Jun 6, 2025 Accepting new patients
The Guidance Center CurrentSince Dec 21, 2025 Accepting new patients

Locations

13101 Allen Rd
Southgate, MI 48195
Phone (734) 785-7701

19401 Northline Rd
Southgate, MI 48195
Phone (734) 785-7718

1 Heritage Dr
Ste 520
Southgate, MI 48195
Phone (734) 215-9800

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

Organizations & group practices 2

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": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1083269922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13511 ARCHDALE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482271335",
            "telephone_number": "313-694-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12421 FIRST AVE S",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481953541",
            "telephone_number": "313-694-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "AMELIA",
        "middle_name": "MARIAH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801114871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.