Sebastian Bach Fastrich, LCSW, LMSW, ICADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801119757 Issued in MI

Practice address

4646 John R St
Detroit, MI 48201-1916

Phone

(313) 576-1000

NPI assigned

Sep 15, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1023788650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011916",
            "telephone_number": "313-576-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011916",
            "telephone_number": "313-576-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7305 N Military Trl",
            "address_purpose": "LOCATION",
            "city": "Riviera Beach",
            "state": "FL",
            "postal_code": "334107417",
            "country_code": "US",
            "telephone_number": "561-422-8262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASTRICH",
        "first_name": "SEBASTIAN",
        "middle_name": "BACH",
        "name_prefix": "Mr.",
        "credential": "LCSW, LMSW, ICADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-15",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21875",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONALLY CERTIFIED ALCOHOL & DRUG COUNSELOR",
            "identifier": "ICADC.0000142",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASTERS LEVEL CERTIFIED ADDICTION'S PROFESSIONAL",
            "identifier": "MCAP.0101133",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ALCOHOL AND DRUG COUNSELOR",
            "identifier": "2-02071",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "6801119757",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.