Individual provider Active NPI

Amanda Jayne Dolan, LMSW

  • Clinical Social Worker
  • Mt Pleasant, MI
National Provider Identifier
1801286901
Registry record updated Dec 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801119543 Issued in MI
Practice address
301 S Crapo St Ste 100
Mt Pleasant, MI 48858-2941
Phone
(989) 772-5938
Fax
(989) 773-1968
NPI assigned
Jan 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6802088428 MI
Clinical Social Worker 1041C0700X 6801119543 MI Primary

Addresses

Primary practice location

301 S Crapo St Ste 100
Mt Pleasant, MI 48858-2941

Mailing address

408 W Webster St
Coleman, MI 48618-9700

Other practice location 1

207 E Railway St
Coleman, MI 48618-9799
Phone (989) 859-8577

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
I20250205000224 MI Practitioner - Clinical Social Worker 5193255214 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6802088428MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Adolan, LLC Clinical CurrentSince Feb 2, 2025 Accepting new patients
Community Mental Health for Central Michigan Clinical CurrentSince Dec 19, 2024 Accepting new patients

Locations

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

301 S Crapo St
Ste 1
Mount Pleasant, MI 48858

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1801286901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 W WEBSTER ST",
            "city": "COLEMAN",
            "state": "MI",
            "postal_code": "486189700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S CRAPO ST STE 100",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582941",
            "telephone_number": "989-772-5938",
            "fax_number": "989-773-1968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 E Railway St",
            "address_purpose": "LOCATION",
            "city": "Coleman",
            "state": "MI",
            "postal_code": "486189799",
            "country_code": "US",
            "telephone_number": "989-859-8577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "AMANDA",
        "middle_name": "JAYNE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802088428",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.