Active NPI
Amy Marie Bade, EDD LIC PSYCHOLOGIST
- Psychologist
- Holland, MI
National Provider Identifier
1811083900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301008394
- Practice address
- 29 West 8TH Street
Suite 240
Holland, MI 49423 - Phone
- (616) 396-1433
- Fax
- (616) 396-9643
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301008394 | MI | Primary |
Addresses
Primary practice location
29 West 8TH Street
Suite 240
Holland, MI 49423
Mailing address
29 West 8TH Street
Suite 240
Holland, MI 49423
Phone (616) 396-1433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008394 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811083900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 WEST 8TH STREET",
"address_2": "SUITE 240",
"city": "HOLLAND",
"state": "MI",
"postal_code": "49423",
"telephone_number": "616-396-1433",
"fax_number": "616-396-9643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 WEST 8TH STREET",
"address_2": "SUITE 240",
"city": "HOLLAND",
"state": "MI",
"postal_code": "49423",
"telephone_number": "616-396-1433",
"fax_number": "616-396-9643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADE",
"first_name": "AMY",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "EDD LIC PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301008394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.