NPIMap

Organization Active NPI

Amplified Life Network, LLC

Doing business as Amplified Life

  • Professional Counselor
  • Byron Center, MI
National Provider Identifier
1558713388
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401003943 Issued in MI
Legal business name
AMPLIFIED LIFE NETWORK, LLC
Doing business as
Amplified Life
Practice address
7791 Byron Center Ave SW
Byron Center, MI 49315-8412
Phone
(616) 724-6943
Fax
(616) 499-2077
NPI assigned
Jul 5, 2016
Last updated
Sep 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Authorized official

Name
Lyle Labardee, LPCNPI 1043537574
Title
President
Phone
(616) 724-6943

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401003943 MI Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

7791 Byron Center Ave SW
Byron Center, MI 49315-8412

Mailing address

7791 Byron Center Ave SW
Byron Center, MI 49315-8412
Phone (616) 724-6943

Other identifiers 1

IdentifierTypeStateIssuer
1043537574OtherMIGENERAL

Other names 1

  • Amplified Life Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200709000263 MI Part B Supplier - Clinic/Group Practice 7214350271 Receives reassigned benefits from 6 practitioners
Practice locations: Byron Center, MI

National Provider Directory

National Provider Directory

Locations

2465 Byron Station Dr SW
Byron Center, MI 49315
Phone (616) 287-3829

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1558713388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7791 BYRON CENTER AVE SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493158412",
            "telephone_number": "616-724-6943",
            "fax_number": "616-499-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7791 BYRON CENTER AVE SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493158412",
            "telephone_number": "616-724-6943",
            "fax_number": "616-499-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMPLIFIED LIFE NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "LABARDEE",
        "authorized_official_first_name": "LYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-724-6943",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401003943",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL",
            "identifier": "1043537574",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amplified Life",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Amplified Life",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Byron Center, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.