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General NPI Number Information
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NPI Number | 1649120619
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Entity Type | Individual
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Provider Name | AMANDA LEE MEREDITH
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Gender | Female
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 675 E BIG BEAVER RD
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City | TROY
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State | MI
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Zip | 48083-1418
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Country | US
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Telephone | 248-677-1412
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Fax |
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Provider Business Mailing Address
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Address Line | 42430 KINGSLEY DR
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City | CLINTON TWP
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State | MI
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Zip | 48038-1675
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Country | US
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Telephone | 586-506-9891
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6451024799
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License Number State | MI
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