Jamie Lee Derevage, LMSW, SSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801106259 Issued in MI

Practice address

21175 15 Mile Rd
Big Rapids, MI 49307-8844

Phone

(231) 796-7651

NPI assigned

Oct 9, 2026

Last updated

Oct 9, 2026By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1791504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1437054632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15760 190TH AVE.",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493079096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21175 15 MILE RD",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493078844",
            "telephone_number": "231-796-7651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Marion Ave",
            "address_purpose": "LOCATION",
            "city": "Big Rapids",
            "state": "MI",
            "postal_code": "493071019",
            "country_code": "US",
            "telephone_number": "231-796-6731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "408 W Bellevue St",
            "address_purpose": "LOCATION",
            "city": "Big Rapids",
            "state": "MI",
            "postal_code": "493071310",
            "country_code": "US",
            "telephone_number": "231-796-6684",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 N State St",
            "address_purpose": "LOCATION",
            "city": "Big Rapids",
            "state": "MI",
            "postal_code": "493071444",
            "country_code": "US",
            "telephone_number": "231-796-9041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEREVAGE",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "credential": "LMSW, SSW",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-10-09",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106259",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MI",
            "license": "909057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian Degram, PA-C
• Monica J Delaney, PA-C
• Courtney Deline
• Savanna Kristine Deloach
• Melissa Ann Deniel, M.D.
• Gail A Desnoyers, MD
• Sarah Marie Devries, OD
• James Ryan Dietrick, D.C.
• Amy Elaine Dinardo, O.D.
• Stacy M Dodd, R.N

• Clinical Social Worker in Big Rapids, MI
• Providers in Big Rapids, 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 Oct 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.