Active NPI
Amanda Elizabeth Henderson
- Clinical Social Worker
- Brighton, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801096618
- Practice address
- 2200 Genoa Business Park Dr Ste 100
Brighton, MI 48114-5328 - Phone
- (517) 882-3732
- NPI assigned
- Sep 7, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 6801096618 | MI | |
| Clinical Social Worker | 1041C0700X | 6801096618 | MI | Primary |
Addresses
Primary practice location
2200 Genoa Business Park Dr Ste 100
Brighton, MI 48114-5328
Mailing address
20500 Eureka Rd Ste 200
Taylor, MI 48180-6394
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2200 Genoa Business Park Dr
Suite 100
Brighton, MI 48114-5328
Phone (810) 494-7180
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801096618 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downriver Mental Health Clinic PC | Clinical | Current | Accepting new patients |
| Downriver Mental Health Clinic PC | Clinical | Current | Accepting new patients |
Locations
2200 Genoa Business Park Dr
Ste 100
Brighton, MI 48114
Phone (810) 449-7180
1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787
20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282
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": "1694044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1295511020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20500 EUREKA RD STE 200",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481806394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 GENOA BUSINESS PARK DR STE 100",
"city": "BRIGHTON",
"state": "MI",
"postal_code": "481145328",
"telephone_number": "517-882-3732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "AMANDA",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-07",
"last_updated": "2023-09-07",
"certification_date": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "MI",
"license": "6801096618",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801096618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brighton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.