Amanda Whitney Bowman, LMSW

Individual provider Active NPI Clinical Social Worker · Middleville, MI

NPI 1790202307 · NPPES record last updated Nov 15, 2022

Key facts

NPI
1790202307
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801114989 (MI)
Practice address
3885 Bender Rd
Middleville, MI 49333-9273
Phone
(616) 267-0785
NPI assigned
Aug 24, 2017
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20221208001031 MI Practitioner - Clinical Social Worker 9931578234 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801114989 MI Yes

Addresses

Primary practice location

3885 Bender Rd
Middleville, MI 49333-9273

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Other names

  • Amanda Whitney Lloyd Former name

Other providers in Middleville, MI

All providers in Middleville, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.