Individual provider Active NPI

Amanda K Dehaan, LMSW

  • Social Worker
  • Wyoming, MI
National Provider Identifier
1720383946
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801086040 Issued in MI
Practice address
1843 RW Berends Dr SW
Wyoming, MI 49519-4955
Phone
(616) 773-2908
NPI assigned
Jan 19, 2011
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801086040 MI Primary

Addresses

Primary practice location

1843 RW Berends Dr SW
Wyoming, MI 49519-4955

Mailing address

1843 RW Berends Dr SW
Wyoming, MI 49519-4955
Phone (616) 460-9412

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
I20151028000969 MI Practitioner - Clinical Social Worker 3476862764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anne Parpas Counseling LLCGroup PAC ID 4880976562, 8 clinicians

Practice addresses (Care Compare)

1055 Gezon Pkwy SW
Integrative Health Consultants
Wyoming, MI 49509-9542
Phone (616) 773-2908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801086040MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Dehaan Counseling, LLC Current Accepting new patients
Anne Parpas Counseling LLC Mental Health CurrentSince Mar 23, 2023 Accepting new patients

Locations

1055 Gezon Pkwy SW
Wyoming, MI 49509
Phone (616) 773-2908

1055 Gezon Pkwy SW
#C
Wyoming, MI 49509
Phone (616) 773-2908

1843 Rw Berends Dr SW
Wyoming, MI 49519
Phone (616) 600-2845

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1720383946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1843 RW BERENDS DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194955",
            "telephone_number": "616-460-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1843 RW BERENDS DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194955",
            "telephone_number": "616-773-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAAN",
        "first_name": "AMANDA",
        "middle_name": "K",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801086040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.