Amanda Lynn Stout, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801116399 Issued in MI

Practice address

5340 Plymouth Road
Suite 202
Ann Arbor, MI 48105

Phone

(734) 462-3210

Fax

(734) 369-6084

NPI assigned

May 9, 2019

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 identifiers 2

Other names 1

• Amanda Lynn Luurtsema Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1710543269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 PLYMOUTH ROAD",
            "address_2": "SUITE 202",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-883-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 PLYMOUTH ROAD",
            "address_2": "SUITE 202",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-462-3210",
            "fax_number": "734-369-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104295",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801116399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PRACTICE",
            "identifier": "6801104295",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6801104295",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "LUURTSEMA",
            "middle_name": "LYNN",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vishvanie Bernadene Stoody, MD
• Lloyd M Stoolman, MD
• Mary Sue Storie, LLMSW
• Dina Marie Stornello, PHARMD
• Phillip Stott, MD
• Jasmine Stout, LLMSW
• Jessica Stout, MSW
• Molly Jean Stout, MD
• Jennifer A Stowitts, CRNA
• Lindsay Elizabeth Stoyka, MD, PHD

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.