Amanda Kerbawy

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301016872 Issued in MI

Practice address

6548 Town Center Dr Ste D
Clarkston, MI 48346

Phone

(248) 382-8207

NPI assigned

Mar 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment NPD

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1326408238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 DEER PATH TRL",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483274350",
            "telephone_number": "651-334-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6548 TOWN CENTER DR STE D",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-382-8207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "441 S Livernois Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Rochester Hills",
            "state": "MI",
            "postal_code": "483072584",
            "country_code": "US",
            "telephone_number": "248-608-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERBAWY",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-04",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015992",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301015992",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kehres Health and Chiropractic
• Veronica Kelty, RN
• Brittany Kenerson
• Kenneth D. Thomas, DDS
• Dena Kenney
• Shane Kerbelis
• Natalie Noeel Kestou, PHARMD
• Brian Edward Keyes, M.P.T.
• Halei G Keyes
• Lasandra Keyes

• Clinical Psychologist in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.