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AMANDA CLARK
NPI 1255835351
Peer Specialist in Southgate, MI

Active since March 22, 2018
13101 ALLEN RD, SOUTHGATE, MI 48195(734) 785-7701 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 21, 2021, Mar 22, 2018 (2 updates tracked since 2018).

About Amanda Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA CLARK (NPI 1255835351) is an individual peer specialist in Southgate, Michigan and active in the NPI registry since March 2018.

NPPES Registry Identity

NPI1255835351
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameAMANDA CLARK
Location Address13101 ALLEN RDSouthgate, MI 48195-2216
Mailing Address13101 Allen RdSouthgate, MI 48195-2216 · (734) 785-7701
Phone(734) 785-7701
Sole ProprietorYes
Enumeration DateMarch 22, 2018
Last NPPES UpdateDecember 21, 20212 updates tracked since enumeration
NPPES CertifiedDecember 21, 2021
✔ NPI 1255835351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
13101 ALLEN RD, Southgate, MI 48195
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LORI SUE MITCHELL RN
Registered Nurse
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7731
SHANNON BAYNAI
Social Worker (Clinical)
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7700
MISS RENEE GOLDSBY
Case Manager/Care Coordinator
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 486-3199
POONAM SHYAM MELWANI
Social Worker
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7705
MR. JAMES GERARD LIVINGSTON LLMSW
Social Worker (Clinical)
13101 ALLEN RD, SUITE 400
SOUTHGATE, MI 48195
Wayne County (734) 785-7705
VICKIE LYNN NOVELL LMSW
Social Worker (Clinical)
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7700
CLAUDETTE JEFFERSON LMSW
Social Worker (Clinical)
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7705
RICKY DAVIS QMHS-B
Case Manager/Care Coordinator
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Clark's NPI number?

The NPI number for Amanda Clark is 1255835351. It was assigned to this individual provider in the NPPES registry on March 22, 2018.

Where is Amanda Clark located?

Amanda Clark practices at 13101 Allen Rd, Southgate, MI 48195. The listed phone number is (734) 785-7701.

What is Amanda Clark's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Amanda Clark was last updated on December 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.