Individual provider Active NPI

Amanda Zwilling, PH.D

  • Clinical Psychologist
  • Detroit, MI
National Provider Identifier
1760146104
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6352000539 Issued in MI
Practice address
261 Mack Ave Ste 555
Detroit, MI 48201-2417
Phone
(313) 745-9763
NPI assigned
Oct 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6352000539 MI Primary

Addresses

Primary practice location

261 Mack Ave Ste 555
Detroit, MI 48201-2417

Mailing address

4010 4TH Street
Detroit, MI 48201
Phone (516) 448-2901

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
I20211104001280 MI Practitioner - Clinical Psychologist 9335537711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

261 Mack Ave
Suite 555
Detroit, MI 48201-2417
Phone (313) 745-9763

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as group
Quality
64.16
Promoting interoperability
100
Improvement activities
40
Cost
73.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6352000539MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan CurrentSince Oct 8, 2021 Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

261 Mack Ave
Ste 555
Detroit, MI 48201
Phone (313) 745-9763

Organizations & group practices 1

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": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1760146104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 4TH STREET",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "516-448-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 MACK AVE STE 555",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012417",
            "telephone_number": "313-745-9763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWILLING",
        "first_name": "AMANDA",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6352000539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.