Amanda Kimberly Fenn

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1560 Leonard St NE
Grand Rapids, MI 49505-5572

Phone

(616) 460-7647

Fax

(616) 458-5430

NPI assigned

Apr 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Amanda Kimberly Burbank Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1650067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650067200000",
    "number": "1346983459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8576 JASONVILLE CT SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493168287",
            "telephone_number": "847-858-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055572",
            "telephone_number": "616-460-7647",
            "fax_number": "616-458-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENN",
        "first_name": "AMANDA",
        "middle_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-16",
        "last_updated": "2022-04-16",
        "certification_date": "2022-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BURBANK",
            "middle_name": "KIMBERLY",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lauren Felten
• Savannah Joy Felten I
• David Robert Felton, DC
• Isabella Felzer-Kim
• Maria Fenicle, MA CCC-SLP
• Katie Fennell, LMSW
• Grace Elizabeth Fennema
• Jason Fennema, CRNA
• Meredith Fennema
• Mara M. Fenton, CTRS

• Mental Health Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.

Verify at the official NPI Registry.