Amplified Life Network, Llc | |
7791 Byron Center Ave Sw, Byron Center, MI 49315-8412 | |
(616) 724-6943 | |
(616) 499-2077 |
Full Name | Amplified Life Network, Llc |
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Type | Facility |
Speciality | Counselor - Professional |
Location | 7791 Byron Center Ave Sw, Byron Center, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558713388 | NPI | - | NPPES |
1043537574 | Other | MI | GENERAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
101YP2500X | Counselor - Professional | 6401003943 (Michigan) | Primary |
Provider Name | Hollie Andrews |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1497949135 PECOS PAC ID: 5193867836 Enrollment ID: I20100119000632 |
Provider Name | Leah A Lord |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1053635607 PECOS PAC ID: 1557681913 Enrollment ID: I20150526002312 |
Provider Name | Sabreen Rae Polavin |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1073904579 PECOS PAC ID: 2062772387 Enrollment ID: I20180207000435 |
Provider Name | Emily Behm Jankowski |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1023474988 PECOS PAC ID: 3375805666 Enrollment ID: I20180327000165 |
Provider Name | Katie Jo Reichard |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1780067546 PECOS PAC ID: 2365866738 Enrollment ID: I20200717001047 |
Provider Name | Cathlene J Young |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1508338864 PECOS PAC ID: 4587074349 Enrollment ID: I20201105001699 |
Provider Name | Amy Beth Harbison |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1376128546 PECOS PAC ID: 9638560519 Enrollment ID: I20220104000836 |
Provider Name | Ruth Gray |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1346665098 PECOS PAC ID: 1557731122 Enrollment ID: I20221227000131 |
Provider Name | Dawn Rodgers-de Fouw |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1609599380 PECOS PAC ID: 3375993702 Enrollment ID: I20231228000676 |
Provider Name | Michael John Wiersma |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1265920342 PECOS PAC ID: 4880037415 Enrollment ID: I20240209003043 |
Provider Name | Caitlin Trezise |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1205676103 PECOS PAC ID: 6901340207 Enrollment ID: I20240627001995 |
Provider Name | Nick Vanzalen |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1063028132 PECOS PAC ID: 8426594235 Enrollment ID: I20240729000563 |
Mailing Address | Practice Location Address |
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Amplified Life Network, Llc 7791 Byron Center Ave Sw, Byron Center, MI 49315-8412 Ph: (616) 724-6943 | Amplified Life Network, Llc 7791 Byron Center Ave Sw, Byron Center, MI 49315-8412 Ph: (616) 724-6943 |