Individual provider Active NPI

Amanda L Tolar, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1467844944
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801116573 Issued in MI
Practice address
1087 4 Mile Rd NE
Grand Rapids, MI 49525-2650
Phone
(616) 437-3906
NPI assigned
Feb 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X L154845 MI
Clinical Social Worker 1041C0700X 6801116573 MI Primary

Addresses

Primary practice location

1087 4 Mile Rd NE
Grand Rapids, MI 49525-2650

Mailing address

1087 4 Mile Rd NE
Grand Rapids, MI 49525-2650
Phone (616) 437-3906

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240509002388 MI Practitioner - Clinical Social Worker 0941641872 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L154845MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda L. Tolar Clinical CurrentSince Dec 3, 2023 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Apr 3, 2024 Accepting new patients
Kent County CMH Authority Past Accepting new patients
Thresholds Inc PastSince Jul 26, 2010 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616

Organizations & group practices 4

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": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1467844944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1087 4 MILE RD NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495252650",
            "telephone_number": "616-437-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1087 4 MILE RD NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495252650",
            "telephone_number": "616-437-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLAR",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "L154845",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801116573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.