Individual provider Active NPI

Amanda Bode Davidson, MS LLP

  • Psychologist
  • Royal Oak, MI
National Provider Identifier
1457810871
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301016482 Issued in MI
Practice address
29488 Woodward Ave # 361
Royal Oak, MI 48073-0903
Phone
(486) 093-1832
Fax
(248) 278-4934
NPI assigned
Mar 15, 2019
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301016482 MI Primary
Clinical Psychologist 103TC0700X 6361999795 MI

Addresses

Primary practice location

29488 Woodward Ave # 361
Royal Oak, MI 48073-0903

Mailing address

29488 Woodward Ave # 361
Royal Oak, MI 48073-0903
Phone (486) 093-1832

Other names 1

  • Ms. Amanda Mary Bode Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6301016482MIMDPsychologist
6361999795MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cypress Counseling Center, P.C. Clinical PastSince Oct 1, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1457810871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29488 WOODWARD AVE # 361",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730903",
            "telephone_number": "486-093-1832",
            "fax_number": "248-278-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29488 WOODWARD AVE # 361",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730903",
            "telephone_number": "486-093-1832",
            "fax_number": "248-278-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "AMANDA",
        "middle_name": "BODE",
        "name_prefix": "Mrs.",
        "credential": "MS LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301016482",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361999795",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BODE",
            "middle_name": "MARY",
            "prefix": "MS.",
            "credential": "MS LLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.