Individual provider Active NPI

Samantha L Cassisi, MS, LCGC

  • Genetic Counselor (M.S.)
  • Lansing, MI
National Provider Identifier
1205573763
Registry record updated Oct 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
License
7201000228 Issued in MI
Practice address
1200 E Michigan Ave Ste 145
Lansing, MI 48912-1897
Phone
(517) 364-5440
Fax
(517) 364-5409
NPI assigned
May 17, 2022
Last updated
Oct 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X 7201000228 MI Primary

Addresses

Primary practice location

1200 E Michigan Ave Ste 145
Lansing, MI 48912-1897

Mailing address

804 Service Rd Ste A109B
East Lansing, MI 48824-7015
Phone (517) 353-2046

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)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696636800000",
    "number": "1205573763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-353-2046",
            "fax_number": "517-364-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE STE 145",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121897",
            "telephone_number": "517-364-5440",
            "fax_number": "517-364-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSISI",
        "first_name": "SAMANTHA",
        "middle_name": "L",
        "credential": "MS, LCGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "MI",
            "license": "7201000228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2023; 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.