Individual provider Active NPI

Amanda Liddicoat, MS, CGC

  • Genetic Counselor (M.S.)
  • Grand Rapids, MI
National Provider Identifier
1144057126
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
License
7201000613 Issued in MI
Practice address
25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526
Phone
(616) 391-2700
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X 7201000613 MI Primary

Addresses

Primary practice location

25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7201000613MIMDGenetic Counselor (M.S.)

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1144057126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MICHIGAN ST NE STE 2100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032526",
            "telephone_number": "616-391-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDICOAT",
        "first_name": "AMANDA",
        "credential": "MS, CGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "MI",
            "license": "7201000613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; 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.