Individual provider Active NPI

Sarah Marie Fitzgerald, LPC

  • Professional Counselor
  • Centreville, MI
National Provider Identifier
1083072490
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401018357 Issued in MI
Practice address
677 E Main St
Centreville, MI 49032-8524
Phone
(269) 467-1000
NPI assigned
Feb 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401018357 MI Primary
Mental Health Counselor 101YM0800X L908633 MI

Addresses

Primary practice location

677 E Main St
Centreville, MI 49032-8524

Mailing address

58375 Blue Stem Cir
Mattawan, MI 49071-9644
Phone (269) 598-5526

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240606002110 MI Practitioner - Mental Health Counselor 2062954936 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L908633MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health Services of St Joseph County CurrentSince May 30, 2024 Accepting new patients

Locations

677 E Main St
Centreville, MI 49032
Phone (269) 467-1001

677 E Main St
Ste A
Centreville, MI 49032
Phone (269) 467-1001

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": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1083072490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58375 BLUE STEM CIR",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490719644",
            "telephone_number": "269-598-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328524",
            "telephone_number": "269-467-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "SARAH",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018357",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "L908633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, MI

Sources for this page

Verify at the official NPI Registry.