Amanda Clark, is a
Peer Specialist based in Southgate, Michigan. Amanda Clark is licensed to practice in * (Not Available) (license number ) and her current practice location is
13101 Allen Rd, Southgate, Michigan. She can be reached at her office (for appointments etc.) via phone at
(734) 785-7701.
NPI number for Amanda Clark is 1255835351 and her current mailing address is 13101 Allen Rd, Southgate, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1255835351.
Healthcare Provider's Profile
Full Name | Amanda Clark |
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Gender | Female |
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Speciality | Peer Specialist |
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Location | 13101 Allen Rd, Southgate, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1255835351
- Provider Enumeration Date: 03/22/2018
- Last Update Date: 12/21/2021
Medical Identifiers
Medical identifiers for Amanda Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1255835351 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
175T00000X | Peer Specialist | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amanda Clark, 13101 Allen Rd, Southgate, MI 48195-2216 Ph: (734) 785-7701 | Amanda Clark, 13101 Allen Rd, Southgate, MI 48195-2216 Ph: (734) 785-7701 |
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