NPIMap

Individual provider Active NPI

Susan Stuart, CRADC

  • Addiction (Substance Use Disorder) Counselor
  • Boyne Falls, MI
National Provider Identifier
1649854142
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2-01653 Issued in MI
Practice address
2594 Springvale Rd
Boyne Falls, MI 49713-9684
Phone
(231) 535-2822
NPI assigned
May 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2-01653 MI Primary

Addresses

Primary practice location

2594 Springvale Rd
Boyne Falls, MI 49713-9684

Mailing address

2329 Center St
Boyne Falls, MI 49713-9268
Phone (231) 758-4566

Other practice location 1

218 Water St
Cheboygan, MI 49721-1606
Phone (231) 535-2822

Other practice location 2

1619 West M32
Gaylord, MI 49735
Phone (231) 535-2822

Other practice location 3

2329 Center St
Boyne Falls, MI 49713-9268
Phone (231) 535-2822

Other practice location 4

8486 M 119
Harbor Springs, MI 49740-8508
Phone (231) 535-2822

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

State licenses

LicenseStateTypeSpecialty
2-01653MIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Walloon Lake Recovery Lodge, LLC CurrentSince May 16, 2021 Accepting new patients
Bear River Primary Care CurrentSince May 16, 2021 Accepting new patients

Locations

2329 Center St
Boyne Falls, MI 49713
Phone (231) 758-4566

2594 Springvale Rd
Boyne Falls, MI 49713
Phone (231) 535-2415

218 Water St
Cheboygan, MI 49721
Phone (231) 751-0070

1619 W M 32
Gaylord, MI 49735
Phone (231) 751-0070

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21307/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1649854142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 CENTER ST",
            "city": "BOYNE FALLS",
            "state": "MI",
            "postal_code": "497139268",
            "telephone_number": "231-758-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2594 SPRINGVALE RD",
            "city": "BOYNE FALLS",
            "state": "MI",
            "postal_code": "497139684",
            "telephone_number": "231-535-2822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "218 Water St",
            "address_purpose": "LOCATION",
            "city": "Cheboygan",
            "state": "MI",
            "postal_code": "497211606",
            "country_code": "US",
            "telephone_number": "231-535-2822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1619 West M32",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "49735",
            "country_code": "US",
            "telephone_number": "231-535-2822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2329 Center St",
            "address_purpose": "LOCATION",
            "city": "Boyne Falls",
            "state": "MI",
            "postal_code": "497139268",
            "country_code": "US",
            "telephone_number": "231-535-2822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8486 M 119",
            "address_purpose": "LOCATION",
            "city": "Harbor Springs",
            "state": "MI",
            "postal_code": "497408508",
            "country_code": "US",
            "telephone_number": "231-535-2822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUART",
        "first_name": "SUSAN",
        "credential": "CRADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "2-01653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boyne Falls, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.