Individual provider Active NPI

Susan Miller-Thompson, MAAT,CAAC

  • Addiction (Substance Use Disorder) Counselor
  • Pontiac, MI
National Provider Identifier
1023155405
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
C-00122 Issued in MI
Practice address
196 Cesar E Chavez Ave
Ste. B-201
Pontiac, MI 48342-1094
Phone
(248) 253-0176
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C-00122 MI Primary

Addresses

Primary practice location

196 Cesar E Chavez Ave
Ste. B-201
Pontiac, MI 48342-1094

Mailing address

2200 Barberry Dr
Shelby Township, MI 48316-0905
Phone (248) 601-1419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C-00122MIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023155405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BARBERRY DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483160905",
            "telephone_number": "248-601-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 CESAR E CHAVEZ AVE",
            "address_2": "STE. B-201",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483421094",
            "telephone_number": "248-253-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER-THOMPSON",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "MAAT,CAAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-00122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.