Healthcare Provider Details

I. General information

NPI: 1487438545
Provider Name (Legal Business Name): AMANDA ELIZABETH BAIL LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NB GRATIOT AVE
MOUNT CLEMENS MI
48043-2304
US

IV. Provider business mailing address

100 NB GRATIOT AVE
MOUNT CLEMENS MI
48043-2304
US

V. Phone/Fax

Practice location:
  • Phone: 586-783-2950
  • Fax: 586-690-4333
Mailing address:
  • Phone: 586-783-2950
  • Fax: 586-690-4333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: