Amy Vanderberg

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1009 W Ridge St Ste C
Marquette, MI 49855-3997

Phone

(906) 228-6545

NPI assigned

May 5, 2022

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Great Lakes Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Escanaba, MI
  • NPI 1679714083
  NPD (past)
• Great Lakes Recovery Centers

  • Substance Abuse Rehabilitation Facility
  • Ironwood, MI
  • NPI 1821267956
  NPD (past)

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1104562941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 S 4TH ST STE C",
            "city": "ISHPEMING",
            "state": "MI",
            "postal_code": "498492168",
            "telephone_number": "906-228-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 W RIDGE ST STE C",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498553997",
            "telephone_number": "906-228-6545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Sandpoint Rd",
            "address_purpose": "LOCATION",
            "city": "Munising",
            "state": "MI",
            "postal_code": "498621406",
            "country_code": "US",
            "telephone_number": "906-291-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "97 S 4th St Ste A",
            "address_purpose": "LOCATION",
            "city": "Ishpeming",
            "state": "MI",
            "postal_code": "498492168",
            "country_code": "US",
            "telephone_number": "906-485-2347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1115 S Hemlock St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Iron Mountain",
            "state": "MI",
            "postal_code": "498013800",
            "country_code": "US",
            "telephone_number": "906-774-2561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Ludington St Ste H",
            "address_purpose": "LOCATION",
            "city": "Escanaba",
            "state": "MI",
            "postal_code": "498293565",
            "country_code": "US",
            "telephone_number": "906-789-3528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERBERG",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Edward Van Eck III
• Jessica Van Overloop
• Colin D Van, CADC
• Hendrik C Vandenende, MD
• Nina Rae Vandenende, NP
• Lyle J Vanderschaaf, MD
• Susan Jean Vandewalle, LMT
• Christina A Vandezande, OT
• Alyssa Laura Vaniman
• James P. Vanlandschoot, DDS

• Addiction (Substance Use Disorder) Counselor in Marquette, MI
• Providers in Marquette, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.