MEDICARE: AMANDA GRACE VOLLMER LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	6802085503	MI
2	1041C0700X	Clinical Social Worker	6851106904	MI

General Provider Information

NPI Number	:	1144875105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA GRACE VOLLMER LMSW

Provider Business Mailing Address
First Line	:	7741 HAROLD AVE
Second Line	:
City	:	JENISON
State	:	MI
Zip	:	49428-7917
Country	:	US
Telephone Number	:	616-502-0275
Fax Number	:

Provider Business Practice Location Address
First Line	:	5445 32ND AVE
Second Line	:
City	:	HUDSONVILLE
State	:	MI
Zip	:	49426-2401
Country	:	US
Telephone Number	:	616-502-0275
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2019
Last Update Date	:	03/02/2026

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Directions to “ AMANDA GRACE VOLLMER LMSW” Practice Location

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