Provider Demographics
NPI:1770392409
Name:VERMEULEN, AMANDA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:VERMEULEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:SCHEERINGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:441 STRATFORD LN
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-2320
Mailing Address - Country:US
Mailing Address - Phone:219-789-2652
Mailing Address - Fax:
Practice Address - Street 1:441 STRATFORD LN
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-2320
Practice Address - Country:US
Practice Address - Phone:219-789-2652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34011531A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical