Individual provider Active NPI

Jodi Lynn Siberski

  • Mental Health Counselor
  • Commerce Township, MI
National Provider Identifier
1487862165
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2045 E West Maple Rd
Suite D-407
Commerce Township, MI 48390-3801
Phone
(248) 624-3811
Fax
(248) 624-0368
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2045 E West Maple Rd
Suite D-407
Commerce Township, MI 48390-3801

Mailing address

114 Orchard Lake Rd
Pontiac, MI 48341-2244
Phone (248) 858-7766

Other identifiers 1

IdentifierTypeStateIssuer
1883825MedicaidMI

Other names 1

  • Jodi Lynn Gawer Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487862165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-858-7766",
            "fax_number": "248-858-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 E WEST MAPLE RD",
            "address_2": "SUITE D-407",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483903801",
            "telephone_number": "248-624-3811",
            "fax_number": "248-624-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBERSKI",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883825",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "GAWER",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Commerce Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.