Individual provider Active NPI

Jamie Lynne Overbaugh, LMSW

  • Clinical Social Worker
  • Clay, MI
National Provider Identifier
1114206463
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093474 Issued in MI
Practice address
7332 Jochar Rd
Clay, MI 48001-3021
Phone
(586) 202-9157
Fax
(810) 821-0610
NPI assigned
Aug 4, 2011
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801093474 MI Primary

Addresses

Primary practice location

7332 Jochar Rd
Clay, MI 48001-3021

Mailing address

7332 Jochar Rd
Clay, MI 48001-3021
Phone (586) 202-9157

Other identifiers 1

IdentifierTypeStateIssuer
6801093474OtherMIDEPT OF LICENSING AND REGULATORY AFFAIRS - LICENSED MASTER SOCIAL WORKER (LMSW)

Other names 1

  • Jamie Lynne Suchoski Former name

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
I20140102001339 MI Practitioner - Clinical Social Worker 3274761937 Reassigns benefits to 2 organizations
Practice locations: Clinton Township, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7332 Jochar Rd
Clay, MI 48001-3021
Phone (586) 202-9157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wandering Path Counseling, LLC CurrentSince Mar 15, 2021 Accepting new patients
Strong Roots Therapy LLC CurrentSince Jul 5, 2022 Accepting new patients
Oakland Family Services CurrentSince Jan 21, 2015 Accepting new patients
Healing Solutions Counseling Clinical Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1114206463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7332 JOCHAR RD",
            "city": "CLAY",
            "state": "MI",
            "postal_code": "480013021",
            "telephone_number": "586-202-9157",
            "fax_number": "810-821-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7332 JOCHAR RD",
            "city": "CLAY",
            "state": "MI",
            "postal_code": "480013021",
            "telephone_number": "586-202-9157",
            "fax_number": "810-821-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERBAUGH",
        "first_name": "JAMIE",
        "middle_name": "LYNNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-04",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LICENSING AND REGULATORY AFFAIRS - LICENSED MASTER SOCIAL WORKER (LMSW)",
            "identifier": "6801093474",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "SUCHOSKI",
            "middle_name": "LYNNE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clay, MI

Sources for this page

Verify at the official NPI Registry.