Active NPI
Amanda Walker, MA LLP CAADC
- Psychologist
- Grand Rapids, MI
National Provider Identifier
1255737649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6361003728
- Practice address
- 300 68TH St SE
Grand Rapids, MI 49548-6927 - Phone
- (616) 544-5000
- NPI assigned
- Nov 12, 2014
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301003728 | MI | |
| Counseling Psychologist | 103TC1900X | 6301014470 | MI | |
| Psychologist | 103T00000X | 6361003728 | MI | Primary |
Addresses
Primary practice location
300 68TH St SE
Grand Rapids, MI 49548-6927
Mailing address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301003728 | MI | MD | Psychologist |
| 6361003728 | MI | MD | Psychologist |
| 6301014470 | MI | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659657600000",
"number": "1255737649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495486927",
"telephone_number": "616-455-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495486927",
"telephone_number": "616-544-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "AMANDA",
"name_prefix": "Ms.",
"credential": "MA LLP CAADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-12",
"last_updated": "2022-08-05",
"certification_date": "2022-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301003728",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301014470",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6361003728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.