Individual provider Active NPI

Jordan Michelle Sanger

  • Mental Health Counselor
  • Kalkaska, MI
National Provider Identifier
1629761747
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6451022953 Issued in MI
Practice address
419 S Coral St
Kalkaska, MI 49646-2503
Phone
(231) 631-6684
NPI assigned
Jun 2, 2023
Last updated
Jun 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6451022953 MI Primary
School Counselor 101YS0200X 4117121 AK

Addresses

Primary practice location

419 S Coral St
Kalkaska, MI 49646-2503

Mailing address

5475 Goodrick Rd
Traverse City, MI 49684-8181
Phone (231) 631-6684

Other practice location 1

425 Boardman Ave
Traverse City, MI 49684-2687
Phone (231) 631-6684

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
I20251201000985 MI Practitioner - Mental Health Counselor 2264925114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6451022953MIMDMental Health Counselor
4117121AKMDSchool Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kalkaska Memorial Health Center CurrentSince Sep 18, 2025 Accepting new patients
Kalkaska Memorial Health Center CurrentSince Sep 18, 2025 Accepting new patients
Traverse City Teen Counseling Current Accepting new patients

Locations

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

Organizations & group practices 3

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": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1629761747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5475 GOODRICK RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848181",
            "telephone_number": "231-631-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S CORAL ST",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496462503",
            "telephone_number": "231-631-6684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 Boardman Ave",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842687",
            "country_code": "US",
            "telephone_number": "231-631-6684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANGER",
        "first_name": "JORDAN",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451022953",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "AK",
            "license": "4117121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalkaska, MI

Sources for this page

Verify at the official NPI Registry.