Organization Active NPI

Beth Sipple Janick LLC

  • Mental Health Counselor
  • East Lansing, MI
National Provider Identifier
1104209493
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4704194601 Issued in MI
Legal business name
BETH SIPPLE JANICK LLC
Practice address
4572 S Hagadorn Rd
Suite 3B
East Lansing, MI 48823-5385
Phone
(517) 410-0729
Fax
(517) 999-3675
NPI assigned
Jul 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Authorized official

Name
Ms. Beth Sipple Janick, NPNPI 1073626057
Title
Nurse Practitioner
Phone
(517) 410-0729

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 4704194601 MI Primary

Addresses

Primary practice location

4572 S Hagadorn Rd
Suite 3B
East Lansing, MI 48823-5385

Mailing address

4572 S Hagadorn Rd
Suite 3B
East Lansing, MI 48823-5385
Phone (517) 410-0729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150810001399 MI Part B Supplier - Clinic/Group Practice 1355656042 Receives reassigned benefits from 1 practitioner
Practice locations: East Lansing, MI

National Provider Directory

National Provider Directory

Locations

4572 S Hagadorn Rd
Ste 3B
East Lansing, MI 48823
Phone (517) 410-0729

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1104209493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4572 S HAGADORN RD",
            "address_2": "SUITE 3B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235385",
            "telephone_number": "517-410-0729",
            "fax_number": "517-999-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4572 S HAGADORN RD",
            "address_2": "SUITE 3B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235385",
            "telephone_number": "517-410-0729",
            "fax_number": "517-999-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH SIPPLE JANICK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-03",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "JANICK",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "SIPPLE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "517-410-0729",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "4704194601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.