Individual provider Active NPI

Derrick Guty, MA, LPC

  • Counselor
  • East Lansing, MI
National Provider Identifier
1629487194
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401013895 Issued in MI
Practice address
1422 W Saginaw St
East Lansing, MI 48823-2434
Phone
(517) 775-3871
Fax
(517) 657-2466
NPI assigned
Aug 8, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401013895 MI Primary

Addresses

Primary practice location

1422 W Saginaw St
East Lansing, MI 48823-2434

Mailing address

1422 W Saginaw St
East Lansing, MI 48823-2434
Phone (517) 775-3871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231227001644 MI Practitioner - Mental Health Counselor 2567812928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401013895MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
SG Counseling & Consulting PLC Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

523 W Ionia St
Lansing, MI 48933
Phone (334) 703-4621

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1629487194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 W SAGINAW ST",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488232434",
            "telephone_number": "517-775-3871",
            "fax_number": "517-657-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 W SAGINAW ST",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488232434",
            "telephone_number": "517-775-3871",
            "fax_number": "517-657-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTY",
        "first_name": "DERRICK",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-08",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401013895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.