Active NPI
Amanda Vergin
- Counselor
- Spring Lake, MI
National Provider Identifier
1265923874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401222869
- Practice address
- 109 N Buchanan St
Spring Lake, MI 49456-1705 - Phone
- (586) 924-0125
- NPI assigned
- May 21, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401222869 | MI | Primary |
Addresses
Primary practice location
109 N Buchanan St
Spring Lake, MI 49456-1705
Mailing address
521 Marion Ave
Grand Haven, MI 49417-2104
Phone (586) 924-0125
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 |
|---|---|---|---|
| 6401222869 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Mercies Counseling Services | Counselor | Current | Accepting new patients |
Locations
109 N Buchanan St
Spring Lake, MI 49456
Phone (586) 924-0125
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.
-
- Counselor
- Spring Lake, MI
- NPI 1043990047
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1265923874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "521 MARION AVE",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494172104",
"telephone_number": "586-924-0125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 N BUCHANAN ST",
"city": "SPRING LAKE",
"state": "MI",
"postal_code": "494561705",
"telephone_number": "586-924-0125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERGIN",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-21",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401222869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.