Amanda Jo Klingensmith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301017379 Issued in MI

Practice address

409 Plymouth Rd Ste 250
Plymouth, MI 48170-1842

Phone

(734) 416-9098

NPI assigned

May 2, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amanda Jo Koehn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1689029290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 PLYMOUTH RD STE 250",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701842",
            "telephone_number": "734-416-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 PLYMOUTH RD STE 250",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701842",
            "telephone_number": "734-416-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGENSMITH",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-02",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301017379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "KOEHN",
            "middle_name": "JO",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Kiser
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• Trenie Klaus
• Emily Klausmeier
• Cara Klonowski
• Bradley Klumpp
• Brianna Paige Klunder
• Knab Pharmacy Inc (wiltse's community pharmacy)
• Kelsey M Knie, DPT

• Clinical Psychologist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.