Individual provider Active NPI

Amanda Marie Connon, LLP

  • Psychologist
  • Chelsea, MI
National Provider Identifier
1144505744
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6361006571 Issued in MI
Practice address
350 North Main Street
Ste 150
Chelsea, MI 48118
Phone
(734) 593-5251
Fax
(734) 593-5255
NPI assigned
Oct 14, 2011
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6361006571 MI Primary

Addresses

Primary practice location

350 North Main Street
Ste 150
Chelsea, MI 48118

Mailing address

24 Frank Lloyd Wright Drive
Ste J2000
Ann Arbor, MI 48105
Phone (734) 747-6766

Other names 1

  • Amanda Torok Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190917003275 MI Practitioner - Psychologist Billing Independently 9335479328 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsea Community Hospital CurrentSince Nov 1, 2018 Accepting new patients
Iha Health Services Corporation CurrentSince Jun 1, 2024 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Jun 1, 2024 Accepting new patients
Chelsea Community Hospital CurrentSince Nov 1, 2018 Accepting new patients
Victor M. Cruz MD, P.C. Past Accepting new patients
St Joseph Mercy Chelsea Inc PastSince Sep 1, 2019 Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

350 N Main St
Ste 150
Chelsea, MI 48118
Phone (734) 593-5251

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1144505744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DRIVE",
            "address_2": "STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NORTH MAIN STREET",
            "address_2": "STE 150",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "48118",
            "telephone_number": "734-593-5251",
            "fax_number": "734-593-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNON",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-14",
        "last_updated": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361006571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "TOROK",
            "credential": "LLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chelsea, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.