Provider Demographics
NPI:1831547744
Name:AMANDA TOMPKINS
Entity type:Organization
Organization Name:AMANDA TOMPKINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-301-2504
Mailing Address - Street 1:255 E BROWN ST STE 230
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6233
Mailing Address - Country:US
Mailing Address - Phone:248-301-2504
Mailing Address - Fax:248-297-6077
Practice Address - Street 1:255 E BROWN ST STE 230
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6233
Practice Address - Country:US
Practice Address - Phone:248-301-2504
Practice Address - Fax:248-297-6077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010872421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty