Individual provider Active NPI

Maria Lynn Sutka

  • Clinical Social Worker
  • Southgate, MI
National Provider Identifier
1831876317
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801066430 Issued in MI
Practice address
19291 Northline Rd
Southgate, MI 48195-2220
Phone
(734) 637-9816
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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 6801066430 MI Primary

Addresses

Primary practice location

19291 Northline Rd
Southgate, MI 48195-2220

Mailing address

1158 Chestnut St
Wyandotte, MI 48192-4917
Phone (734) 637-9817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829004234 MI Practitioner - Clinical Social Worker 2466815022 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Guidance Center CurrentSince Jul 22, 2023 Accepting new patients

Locations

13101 Allen Rd
Southgate, MI 48195
Phone (734) 785-7701

19291 Northline Rd
Southgate, MI 48195
Phone (734) 287-1500

Organizations & group practices 1

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": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1831876317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 CHESTNUT ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924917",
            "telephone_number": "734-637-9817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19291 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952220",
            "telephone_number": "734-637-9816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTKA",
        "first_name": "MARIA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801066430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.