Individual provider Active NPI

Amanda Marie Herrick, MA, LLP, LPC

  • Counseling Psychologist
  • Cadillac, MI
National Provider Identifier
1780102848
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6361007739 Issued in MI
Practice address
9116 E 13TH St
Cadillac, MI 49601
Phone
(231) 409-5117
NPI assigned
Sep 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401018548 MI
Counseling Psychologist 103TC1900X 6361007739 MI Primary

Addresses

Primary practice location

9116 E 13TH St
Cadillac, MI 49601

Mailing address

9116 E 13TH St
Cadillac, MI 49601-8126
Phone (231) 429-3645

Other practice location 1

655 E Cedar Ave
Gladwin, MI 48624-2215
Phone (989) 429-9295

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
I20250320001474 MI Practitioner - Mental Health Counselor 4880116789 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401018548MIMDProfessional Counselor
6361007739MIMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health for Central Michigan Counselor CurrentSince Jan 19, 2025 Accepting new patients
Community Mental Health for Central Michigan Counselor PastSince Nov 24, 2019 Accepting new patients
Lakeshore Community Counseling Center PLLC PastSince Feb 1, 2023 Accepting new patients

Locations

655 E Cedar Ave
Gladwin, MI 48624
Phone (989) 426-9295

218 Fast Ice Dr
Midland, MI 48642
Phone (989) 631-2320

301 S Crapo St
Ste 200
Mt Pleasant, MI 48858
Phone (989) 772-5938

301 S Crapo St
Ste 100
Mt Pleasant, MI 48858
Phone (989) 772-5938

Organizations & group practices 3

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": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1780102848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9116 E 13TH ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018126",
            "telephone_number": "231-429-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9116 E 13TH ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "49601",
            "telephone_number": "231-409-5117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 E Cedar Ave",
            "address_purpose": "LOCATION",
            "city": "Gladwin",
            "state": "MI",
            "postal_code": "486242215",
            "country_code": "US",
            "telephone_number": "989-429-9295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRICK",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "MA, LLP, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018548",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6361007739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

Verify at the official NPI Registry.