Individual provider Active NPI

Millie Allean Paterson, LMSW, CAADC, MBA

  • Clinical Social Worker
  • Sandusky, MI
National Provider Identifier
1861570194
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801059994 Issued in MI
Practice address
119 E Sanilac Rd
Suite 8
Sandusky, MI 48471-1184
Phone
(810) 689-4760
Fax
(810) 958-1295
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 6801059994 MI
Clinical Social Worker 1041C0700X 6801059994 MI Primary

Addresses

Primary practice location

119 E Sanilac Rd
Suite 8
Sandusky, MI 48471-1184

Mailing address

3317 Blue Water Dr
Burtchville, MI 48059-2505
Phone (810) 689-4760

Other practice location 1

5730 Main St
Lexington, MI 48450-8800
Phone (810) 689-4760

Other identifiers 1

IdentifierTypeStateIssuer
1063821650MedicaidMI

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
I20040924001069 MI Practitioner - Clinical Social Worker 1759350994 Reassigns benefits to 1 organization
Practice locations: Sandusky, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

119 E Sanilac Rd
Suite 8
Sandusky, MI 48471-1184
Phone (810) 689-4760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
6801059994MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Millie a. Paterson, PLLC Clinical CurrentSince Dec 1, 2014 Accepting new patients
Lakeshore Therapy PLLC Clinical PastSince Dec 1, 2014 Accepting new patients
Sanilac County Community Mental Health Authority PastSince Sep 6, 2005 Accepting new patients

Locations

5730 Main St
Lexington, MI 48450
Phone (810) 359-2605

119 E Sanilac Rd
Ste 8
Sandusky, MI 48471
Phone (810) 689-4760

51 Austin St
Sandusky, MI 48471
Phone (810) 648-5244

Organizations & group practices 3

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1861570194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 BLUE WATER DR",
            "city": "BURTCHVILLE",
            "state": "MI",
            "postal_code": "480592505",
            "telephone_number": "810-689-4760",
            "fax_number": "810-958-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E SANILAC RD",
            "address_2": "SUITE 8",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711184",
            "telephone_number": "810-689-4760",
            "fax_number": "810-958-1295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5730 Main St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "MI",
            "postal_code": "484508800",
            "country_code": "US",
            "telephone_number": "810-689-4760",
            "fax_number": "810-958-1295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATERSON",
        "first_name": "MILLIE",
        "middle_name": "ALLEAN",
        "name_prefix": "Ms.",
        "credential": "LMSW, CAADC, MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MI",
            "license": "6801059994",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801059994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063821650",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, MI

Sources for this page

Verify at the official NPI Registry.