Organization Active NPI

Etch

  • Social Worker
  • East Lansing, MI
National Provider Identifier
1689075806
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
ETCH
Practice address
909 Abbot Rd Ste B
East Lansing, MI 48823-3168
Phone
(269) 430-3122
NPI assigned
Sep 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Mary Beth Houpt
Title
Credentialing
Phone
(517) 676-9797

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

909 Abbot Rd Ste B
East Lansing, MI 48823-3168

Mailing address

PO Box 10
Mason, MI 48854-0010
Phone (517) 676-9788

National Provider Directory

National Provider Directory

Locations

909 Abbot Rd
Ste B
East Lansing, MI 48823
Phone (269) 430-3122

838 Louisa St
Ste 1D
Lansing, MI 48911
Phone (517) 481-4800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1689075806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010",
            "telephone_number": "517-676-9788",
            "fax_number": "517-676-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 ABBOT RD STE B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233168",
            "telephone_number": "269-430-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "HOUPT",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "517-676-9797"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.