Individual provider Active NPI

Amanda Freeman

  • Social Worker
  • Kalamazoo, MI
National Provider Identifier
1194267807
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801113847 Issued in MI
Practice address
3317 Greenleaf Blvd
Kalamazoo, MI 49008-2516
Phone
(269) 425-3076
NPI assigned
Nov 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6801100047 MI
Social Worker 104100000X 6801113847 MI Primary

Addresses

Primary practice location

3317 Greenleaf Blvd
Kalamazoo, MI 49008-2516

Mailing address

519 S Park St
Kalamazoo, MI 49007-5117
Phone (269) 903-0560

Other practice location 1

519 S Park St
Kalamazoo, MI 49007-5117
Phone (269) 903-0560

Other names 1

  • Amada Terberg Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220617001864 MI Practitioner - Clinical Social Worker 4183003387 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801100047MIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brennerhelp LLC Social Worker CurrentSince Jun 16, 2022 Accepting new patients
Kalamazoo Probation Enhancement Program Addiction (Substance Use Disorder) Past Accepting new patients

Locations

4415 Duke St
Ste 1W
Kalamazoo, MI 49008
Phone (269) 216-3337

3317 Greenleaf Blvd
Kalamazoo, MI 49008
Phone (269) 216-3337

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1194267807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 S PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075117",
            "telephone_number": "269-903-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 GREENLEAF BLVD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082516",
            "telephone_number": "269-425-3076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "519 S Park St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075117",
            "country_code": "US",
            "telephone_number": "269-903-0560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-11",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6801100047",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801113847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMADA",
            "last_name": "TERBERG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.