Individual provider Active NPI

Sara Joanne Sutherland, LMSW

  • Social Worker
  • Richland, MI
National Provider Identifier
1063004455
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801106679 Issued in MI
Practice address
11205 Littlefield
Richland, MI 49083-9448
Phone
(269) 250-0794
NPI assigned
Feb 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801106679 MI Primary
Clinical Social Worker 1041C0700X 6801106679 MI

Addresses

Primary practice location

11205 Littlefield
Richland, MI 49083-9448

Mailing address

11205 Littlefield
Richland, MI 49083-9448
Phone (269) 250-0794

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.greatlakespsychologygroup.com/therapists/sara-sutherland/ Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210811003057 MI Practitioner - Clinical Social Worker 5193129278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard Kneip PHD PC 243 clinicians

Practice addresses (Care Compare)

4341 S Westnedge Ave
1205 Kalamazoo
Kalamazoo, MI 49008-3284
Phone (800) 693-1916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Aug 10, 2021 Accepting new patients

Locations

6548 Town Center Dr
Ste D
Clarkston, MI 48346
Phone (248) 212-8739

4341 S Westnedge Ave
Ste 1205
Kalamazoo, MI 49008
Phone (248) 716-5125

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1063004455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11205 LITTLEFIELD",
            "city": "RICHLAND",
            "state": "MI",
            "postal_code": "490839448",
            "telephone_number": "269-250-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11205 LITTLEFIELD",
            "city": "RICHLAND",
            "state": "MI",
            "postal_code": "490839448",
            "telephone_number": "269-250-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "SARA",
        "middle_name": "JOANNE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-07",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801106679",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106679",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.greatlakespsychologygroup.com/therapists/sara-sutherland/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "11205 Littlefield",
            "city": "Richland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490839448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richland, MI

Sources for this page

Verify at the official NPI Registry.