Amanda Dawn Axelrod, MS, LLMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4151001155 Issued in MI

Practice address

711 E Grand River Ave Ste a
Brighton, MI 48116-2474

Phone

(936) 446-9476

NPI assigned

Aug 26, 2024

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1093548802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27112 GATEWAY DR S APT 106",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344954",
            "telephone_number": "936-446-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E GRAND RIVER AVE STE A",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481162474",
            "telephone_number": "936-446-9476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27112 Gateway Dr S Apt 106",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483344954",
            "country_code": "US",
            "telephone_number": "936-446-9476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AXELROD",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "credential": "MS, LLMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4151001155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Brighton, MI
• Providers in Brighton, MI by specialty
• Marriage & Family Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.