Individual provider Active NPI

Susan E Smallwood, LPC

  • Professional Counselor
  • Grand Blanc, MI
National Provider Identifier
1104135961
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401224713 Issued in MI
Practice address
7227 Fenton Rd
Grand Blanc, MI 48439-8961
Phone
(810) 771-4074
Fax
(810) 866-4450
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401224713 MI Primary

Addresses

Primary practice location

7227 Fenton Rd
Grand Blanc, MI 48439-8961

Mailing address

7227 Fenton Rd
Grand Blanc, MI 48439-8961
Phone (810) 771-4074

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
I20250114002004 MI Practitioner - Mental Health Counselor 5294263539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creekside Counseling Group LLCGroup PAC ID 9133521255, 33 clinicians

Practice addresses (Care Compare)

7227 Fenton Rd
Grand Blanc, MI 48439-8961
Phone (810) 771-4074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401224713MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Counseling Group LLC Counselor CurrentSince Dec 3, 2024 Accepting new patients

Locations

10801 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 771-4074

7227 Fenton Rd
Grand Blanc, MI 48439
Phone (810) 694-2770

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": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1104135961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 FENTON RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398961",
            "telephone_number": "810-771-4074",
            "fax_number": "810-866-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 FENTON RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398961",
            "telephone_number": "810-771-4074",
            "fax_number": "810-866-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLWOOD",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401224713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.