Sydney Dershem

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

128 S Cochran Ave
Charlotte, MI 48813-1510

Phone

(517) 325-9090

NPI assigned

Jun 11, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Samaritas Lutheran Social Services of Michigan

  • Addiction (Substance Use Disorder) Counselor
  • Charlotte, MI
  • NPI 1972860005
  NPD

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1467294371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4596 W TOWNSEND RD",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488799628",
            "telephone_number": "989-640-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 S COCHRAN AVE",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131510",
            "telephone_number": "517-325-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERSHEM",
        "first_name": "SYDNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Thomas Davis, D.C.
• Zoe Ann Davis, MSW
• DCC PC
• Kory V. Deason, M.D.
• Debra S Somervill LMSW LLC
• Lynn Deweese
• Adam M Dewitt, DC
• Casey Dixon
• Cheryl Duffey
• Jeffery Duncan, DPT

• Addiction (Substance Use Disorder) Counselor in Charlotte, MI
• Providers in Charlotte, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.