Healthcare Provider Details

I. General information

NPI: 1467285924
Provider Name (Legal Business Name): AMBER L SPEEDY BSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3665 BAY RD
SAGINAW MI
48603-2445
US

IV. Provider business mailing address

203 S WASHINGTON AVE STE 30
SAGINAW MI
48607-1217
US

V. Phone/Fax

Practice location:
  • Phone: 989-799-6542
  • Fax:
Mailing address:
  • Phone: 989-209-3250
  • Fax: 892-093-2509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number6852094429
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: