Individual provider Active NPI

Amanda Dawn Smith

  • Counselor
  • Southfield, MI
National Provider Identifier
1205107455
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401225207 Issued in MI
Practice address
29000 Inkster Rd
Southfield, MI 48034-1097
Phone
(517) 367-0670
Fax
(517) 367-0681
NPI assigned
Jan 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401225207 MI Primary

Addresses

Primary practice location

29000 Inkster Rd
Southfield, MI 48034-1097

Mailing address

2950 W Howell Rd
Mason, MI 48854-9329
Phone (517) 367-0670

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
I20251003002411 MI Practitioner - Mental Health Counselor 2668978040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DBT Institute of MiGroup PAC ID 9537448774, 12 clinicians

Practice addresses (Care Compare)

2950 W Howell Rd
Mason, MI 48854-9329
Phone (517) 367-0670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DBT Institute of Mi CurrentSince Aug 26, 2025 Accepting new patients
DBT Institute of Mi CurrentSince Aug 26, 2025 Accepting new patients

Locations

2950 W Howell Rd
Mason, MI 48854
Phone (517) 367-0670

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": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1205107455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 W HOWELL RD",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488549329",
            "telephone_number": "517-367-0670",
            "fax_number": "517-367-0681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29000 INKSTER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341097",
            "telephone_number": "517-367-0670",
            "fax_number": "517-367-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-19",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401225207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.