Active NPI
George M Mariutza, LLMSW CADCM
- Social Worker
- Sandusky, MI
National Provider Identifier
1306096953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- L1916956
- Practice address
- 171 Dawson St
Sandusky, MI 48471-1062 - Phone
- (810) 648-4098
- NPI assigned
- Sep 19, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | L1916956 | MI | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1-04857 | MI |
Addresses
Primary practice location
171 Dawson St
Sandusky, MI 48471-1062
Mailing address
10 Peterboro St
Detroit, MI 48201-2722
Phone (313) 833-4627
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 |
|---|---|---|---|
| 1-04857 | MI | MD | Addiction (Substance Use Disorder) Counselor |
| L1916956 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309478400000",
"number": "1306096953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 PETERBORO ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012722",
"telephone_number": "313-833-4627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 DAWSON ST",
"city": "SANDUSKY",
"state": "MI",
"postal_code": "484711062",
"telephone_number": "810-648-4098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIUTZA",
"first_name": "GEORGE",
"middle_name": "M",
"credential": "LLMSW CADCM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-19",
"last_updated": "2011-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "L1916956",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "1-04857",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandusky, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.