Individual provider Active NPI

Sujean Drake, LMSW

  • Clinical Social Worker
  • Ludington, MI
National Provider Identifier
1669408829
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801089667 Issued in MI
Practice address
239 N Jebavy Dr # a-3
Ludington, MI 49431-2910
Phone
(231) 578-9524
Fax
(231) 425-4036
NPI assigned
Jun 22, 2006
Last updated
Nov 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801089667 MI Primary

Addresses

Primary practice location

239 N Jebavy Dr # a-3
Ludington, MI 49431-2910

Mailing address

239 N Jebavy Dr # a-3
Ludington, MI 49431-2910
Phone (231) 578-9524

Other names 1

  • Sujean Meine 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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Associates LLC Clinical PastSince Jan 16, 2009 Accepting new patients
Valmoor LLC Clinical PastSince Jan 21, 2004 Accepting new patients

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, 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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1669408829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 N JEBAVY DR # A-3",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312910",
            "telephone_number": "231-578-9524",
            "fax_number": "231-425-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 N JEBAVY DR # A-3",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312910",
            "telephone_number": "231-578-9524",
            "fax_number": "231-425-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "SUJEAN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801089667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUJEAN",
            "last_name": "MEINE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.