Individual provider Active NPI

Amy Sue Da Silva, LMSW

  • Social Worker
  • Kentwood, MI
National Provider Identifier
1528401254
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801093753 Issued in MI
Practice address
4561 Meadowlawn Dr SE
Kentwood, MI 49512-5413
Phone
(616) 240-5711
NPI assigned
Apr 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3045640 MI
Social Worker 104100000X 6801093753 MI Primary

Addresses

Primary practice location

4561 Meadowlawn Dr SE
Kentwood, MI 49512-5413

Mailing address

4561 Meadowlawn Dr SE
Kentwood, MI 49512-5413
Phone (616) 240-5711

Other names 1

  • Miss Amy Sue Powell Former name

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
I20151211001946 MI Practitioner - Clinical Social Worker 9931400124 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3045640MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Richard Kneip, PH.D., P.C. CurrentSince Mar 14, 2024 Accepting new patients

Locations

6548 Town Center Dr
Ste D
Clarkston, MI 48346
Phone (248) 212-8739

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

Interoperability endpoints

  • Direct secure messaging: amydasilva@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1528401254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4561 MEADOWLAWN DR SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495125413",
            "telephone_number": "616-240-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4561 MEADOWLAWN DR SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495125413",
            "telephone_number": "616-240-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DA SILVA",
        "first_name": "AMY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "3045640",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801093753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "POWELL",
            "middle_name": "SUE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kentwood, MI

Sources for this page

Verify at the official NPI Registry.