MEDICARE: AMANDA LEE MEREDITH

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	101YM0800X	Mental Health Counselor	6451024799	MI

General Provider Information

NPI Number	:	1649120619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA LEE MEREDITH

Provider Business Mailing Address
First Line	:	42430 KINGSLEY DR
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48038-1675
Country	:	US
Telephone Number	:	586-506-9891
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 E BIG BEAVER RD
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-1418
Country	:	US
Telephone Number	:	248-677-1412
Fax Number	:

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

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	01/30/2026

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Directions to “ AMANDA LEE MEREDITH ” Practice Location

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