Mercedes B Saurbaugh, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801088733 Issued in MI

Practice address

7178 Butternut Dr
West Olive, MI 49460-9734

Phone

(616) 498-0958

Fax

(616) 344-1034

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mercedes B Mervenne Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Into the Woods Retreat

  • Community/Behavioral Health Agency
  • West Olive, MI
  • NPI 1962876243
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1356465868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7178 BUTTERNUT DR",
            "city": "WEST OLIVE",
            "state": "MI",
            "postal_code": "494609734",
            "telephone_number": "616-498-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7178 BUTTERNUT DR",
            "city": "WEST OLIVE",
            "state": "MI",
            "postal_code": "494609734",
            "telephone_number": "616-498-0958",
            "fax_number": "616-344-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAURBAUGH",
        "first_name": "MERCEDES",
        "middle_name": "B",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MERCEDES",
            "last_name": "MERVENNE",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Brandi Rose Sickmund, LLMSW
• Sides Psychological Consulting, LLC
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• Clinical Social Worker in West Olive, MI
• Providers in West Olive, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.