Amanda Joyce Bolanowski, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

207 1St St
Jackson, MI 49201-2102

Phone

(517) 998-4673

Fax

(517) 998-0005

NPI assigned

Sep 18, 2020

Last updated

Sep 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A Healing Place, LLC

  • Psychologist
  • Jackson, MI
  • NPI 1275885881

  Clinical

  NPD

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1831705482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 1ST ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012102",
            "telephone_number": "517-998-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 1ST ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012102",
            "telephone_number": "517-998-4673",
            "fax_number": "517-998-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOWSKI",
        "first_name": "AMANDA",
        "middle_name": "JOYCE",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jalen Kainick Bogan, M.A, LPC
• Kelli Lynn Bogue, AU.D.
• Kevin Scott Bohlen, PA-C
• Amber Lyn Bohnett-Smith, MA, LLPC, NCC
• Bok Medical Service
• Kristina Bolante, PT
• Cheyenne Tayler Bolenbaugh, CTRS
• Brandon James Bolin
• Makayla Bolin
• Judith A Bolton, CRNA

• Clinical Social Worker in Jackson, MI
• Providers in Jackson, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.