Individual provider Active NPI

Sarah Lietzow Witherell, PH.D., LP

  • Clinical Child & Adolescent Psychologist
  • Detroit, MI
National Provider Identifier
1083921563
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
6301015705 Issued in MI
Practice address
79 W Alexandrine St
Detroit, MI 48201-2015
Phone
(313) 831-5535
NPI assigned
Sep 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 6301015705 MI Primary

Addresses

Primary practice location

79 W Alexandrine St
Detroit, MI 48201-2015

Mailing address

79 W Alexandrine St
Detroit, MI 48201-2015
Phone (313) 831-5535

Other names 1

  • Ms. Sarah Janice Lietzow Former name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301015705MIMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Children'S Center of Wayne Co., Inc. Past Accepting new patients

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": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1083921563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-831-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-831-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERELL",
        "first_name": "SARAH",
        "middle_name": "LIETZOW",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301015705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "LIETZOW",
            "middle_name": "JANICE",
            "prefix": "MS.",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.