Organization Active NPI

Jason G Stentoumis

  • Psychologist
  • Lansing, MI
National Provider Identifier
1780862789
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301013410 Issued in MI
Legal business name
JASON G STENTOUMIS
Practice address
2535 E Mount Hope Ave
Lansing, MI 48910-1913
Phone
(517) 999-3935
Fax
(517) 372-2542
NPI assigned
Feb 1, 2008
Last updated
Apr 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Authorized official

Name
Jason G Stentoumis, PHDNPI 1730375106
Title
Owner
Phone
(517) 999-3935

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 6301013410 MI Primary

Addresses

Primary practice location

2535 E Mount Hope Ave
Lansing, MI 48910-1913

Mailing address

PO Box 2257
Chesterton, IN 46304-0357
Phone (517) 676-9788

Other identifiers 1

IdentifierTypeStateIssuer
680C315670OtherMIBLUE SHIELD OF MICHIGAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365465600000",
    "number": "1780862789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357",
            "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": "2535 E MOUNT HOPE AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489101913",
            "telephone_number": "517-999-3935",
            "fax_number": "517-372-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON G STENTOUMIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2013-04-09",
        "status": "A",
        "authorized_official_last_name": "STENTOUMIS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-999-3935",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MICHIGAN",
            "identifier": "680C315670",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; 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.