Provider Demographics
NPI:1881330447
Name:KEARNS, AMANDA JEAN (LMSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JEAN
Last Name:KEARNS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5292 VOICE RD
Mailing Address - Street 2:
Mailing Address - City:KINGSLEY
Mailing Address - State:MI
Mailing Address - Zip Code:49649-9607
Mailing Address - Country:US
Mailing Address - Phone:231-715-1568
Mailing Address - Fax:
Practice Address - Street 1:5292 VOICE RD
Practice Address - Street 2:
Practice Address - City:KINGSLEY
Practice Address - State:MI
Practice Address - Zip Code:49649-9607
Practice Address - Country:US
Practice Address - Phone:231-715-1568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801120053101Y00000X
MI685114854101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor