Active NPI
Marilyn S Sytsma, LMSW
- Clinical Social Worker
- Alpena, MI
National Provider Identifier
1396885224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801066322
- Practice address
- 112 S 1St Ave
Alpena, MI 49707-2812 - Phone
- (989) 358-9393
- NPI assigned
- Feb 8, 2007
- Last updated
- Aug 7, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801066322 | MI | Primary |
Addresses
Primary practice location
112 S 1St Ave
Alpena, MI 49707-2812
Mailing address
5574 Bay Shore Dr
Presque Isle, MI 49777-8465
Phone (989) 595-3282
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801066322 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morning Glory Solutions Inc | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249603200000",
"number": "1396885224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5574 BAY SHORE DR",
"city": "PRESQUE ISLE",
"state": "MI",
"postal_code": "497778465",
"telephone_number": "989-595-3282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 S 1ST AVE",
"city": "ALPENA",
"state": "MI",
"postal_code": "497072812",
"telephone_number": "989-358-9393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYTSMA",
"first_name": "MARILYN",
"middle_name": "S",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2009-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801066322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alpena, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.