Individual provider Active NPI

Jane Fetzer, MA LPC

  • Professional Counselor
  • Bay City, MI
National Provider Identifier
1841481348
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401006762 Issued in MI
Practice address
1420 Center Ave
Bay City, MI 48708-6110
Phone
(989) 686-1990
Fax
(989) 686-0474
NPI assigned
Aug 8, 2007
Last updated
Aug 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401006762 MI Primary

Addresses

Primary practice location

1420 Center Ave
Bay City, MI 48708-6110

Mailing address

1420 Center Ave
Bay City, MI 48708-6110
Phone (989) 686-1990

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401006762MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mt. Pleasant Community Counseling Assoc. PC Professional Past Accepting new patients
Elaine Walcott LMSW PLLC Past 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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1841481348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 CENTER AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086110",
            "telephone_number": "989-686-1990",
            "fax_number": "989-686-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 CENTER AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086110",
            "telephone_number": "989-686-1990",
            "fax_number": "989-686-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETZER",
        "first_name": "JANE",
        "credential": "MA LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401006762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.