Active NPI
Lance Satterthwaite, LMSW
- Mental Health Counselor
- Jackson, MI
National Provider Identifier
1164540621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6801079353
- Practice address
- 330 W Michigan Ave
Jackson, MI 49201-2121 - Phone
- (517) 787-7920
- Fax
- (517) 787-2440
- NPI assigned
- Mar 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6801079353 | MI | Primary |
Addresses
Primary practice location
330 W Michigan Ave
Jackson, MI 49201-2121
Mailing address
110 Sagamore St
Jackson, MI 49203-5360
Phone (517) 787-7920
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801079353 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164540621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 SAGAMORE ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492035360",
"telephone_number": "517-787-7920",
"fax_number": "517-787-2440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 W MICHIGAN AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012121",
"telephone_number": "517-787-7920",
"fax_number": "517-787-2440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SATTERTHWAITE",
"first_name": "LANCE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6801079353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.