Individual provider Active NPI

Amanda Varda

  • Clinical Social Worker
  • Portage, MI
National Provider Identifier
1437734589
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801109170 Issued in MI
Practice address
614 Romence Rd Ste 245
Portage, MI 49024-3613
Phone
(269) 615-7637
NPI assigned
Mar 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801109170 MI Primary

Addresses

Primary practice location

614 Romence Rd Ste 245
Portage, MI 49024-3613

Mailing address

2659 Green Oak LN
Kalamazoo, MI 49004-3768
Phone (906) 396-9822

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avarda@kzoofamilycounseling.com Direct Kalamazoo Child and Family Counseling, PLLC

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

LicenseStateTypeSpecialty
6801109170MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kalamazoo Child and Family Counseling, PLLC Clinical CurrentSince Oct 16, 2022 Accepting new patients

Locations

614 Romence Rd
Ste 245
Portage, MI 49024
Phone (269) 615-7637

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.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1437734589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2659 GREEN OAK LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490043768",
            "telephone_number": "906-396-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 ROMENCE RD STE 245",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490243613",
            "telephone_number": "269-615-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDA",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801109170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avarda@kzoofamilycounseling.com",
            "affiliation": "Y",
            "endpointDescription": "secure email",
            "affiliationName": "Kalamazoo Child and Family Counseling, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "614 Romence Rd Ste 245",
            "city": "Portage",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490243613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.