Amanda Song Hee Vandenbusch, MA, LLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401011593 Issued in MI

Practice address

2045 E West Maple Rd
Suite D-407
Commerce Township, MI 48390-3801

Phone

(248) 624-3811

Fax

(248) 624-0368

NPI assigned

May 25, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274745600000",
    "number": "1154640522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-858-7766",
            "fax_number": "248-858-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 E WEST MAPLE RD",
            "address_2": "SUITE D-407",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483903801",
            "telephone_number": "248-624-3811",
            "fax_number": "248-624-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBUSCH",
        "first_name": "AMANDA",
        "middle_name": "SONG HEE",
        "credential": "MA, LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-25",
        "last_updated": "2010-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401011593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883825",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Commerce Township, MI
• Providers in Commerce Township, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; 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.