Sara Alice Fellows, PCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401016814 Issued in MI

Practice address

3604 Clarkston Rd. Lake Orion Counseling Center
3604 Clarkston Rd.
Clarkston, MI 48316

Phone

(248) 595-9969

Fax

(248) 814-0361

NPI assigned

Nov 2, 2006

Last updated

Nov 19, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1801974217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53060 RUANN DR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483162559",
            "telephone_number": "330-412-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 CLARKSTON RD. LAKE ORION COUNSELING CENTER",
            "address_2": "3604 CLARKSTON RD.",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48316",
            "telephone_number": "248-595-9969",
            "fax_number": "248-814-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLOWS",
        "first_name": "SARA",
        "middle_name": "ALICE",
        "name_prefix": "Mrs.",
        "credential": "PCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401016814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2643616",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.