Active NPI
Amelia Rose Marciniak, MT-BC
- Music Therapist
- Kalamazoo, MI
National Provider Identifier
1174384655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 18546
- Practice address
- 5955 W Main St
Kalamazoo, MI 49009-9101 - Phone
- (269) 329-0730
- NPI assigned
- Jan 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 18546 | MI | Primary |
Addresses
Primary practice location
5955 W Main St
Kalamazoo, MI 49009-9101
Mailing address
1585 Church St
Baroda, MI 49101-9773
Phone (269) 779-3449
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18546 | MI | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705881600000",
"number": "1174384655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1585 CHURCH ST",
"city": "BARODA",
"state": "MI",
"postal_code": "491019773",
"telephone_number": "269-779-3449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5955 W MAIN ST",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490099101",
"telephone_number": "269-329-0730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCINIAK",
"first_name": "AMELIA",
"middle_name": "ROSE",
"credential": "MT-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-22",
"last_updated": "2024-01-22",
"certification_date": "2024-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "MI",
"license": "18546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.