Amanda Ludlow, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401222730 Issued in MI

Practice address

17325 Van Wagoner Rd
Spring Lake, MI 49456-9702

Phone

(616) 847-5145

NPI assigned

Oct 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: amanda.ludlow.p1@direct.nextgenshare.com

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1134761968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17325 VAN WAGONER RD",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "616-847-5145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 N Maple St",
            "address_purpose": "LOCATION",
            "city": "Grant",
            "state": "MI",
            "postal_code": "493277900",
            "country_code": "US",
            "telephone_number": "231-834-0444",
            "fax_number": "231-834-0200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 68th St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495486927",
            "country_code": "US",
            "telephone_number": "616-455-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "331 E State Rd Rm N8",
            "address_purpose": "LOCATION",
            "city": "Grant",
            "state": "MI",
            "postal_code": "493278504",
            "country_code": "US",
            "telephone_number": "231-834-2376 x5485",
            "fax_number": "231-834-5186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUDLOW",
        "first_name": "AMANDA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401222730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda.ludlow.p1@direct.nextgenshare.com",
            "affiliation": "N",
            "address_1": "331 E State Rd Rm N8",
            "city": "Grant",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493278504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Justin J Lyons, DPT
• Kathleen Madonna Mackenna, P.T.
• Mark B Mahacek, PSYD
• Kayla Maine, LPTA
• Kristen J Marsman, PT, DPT

• Professional Counselor in Spring Lake, MI
• Providers in Spring Lake, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.