Sacred Oak Counseling, P.L.L.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SACRED OAK COUNSELING, P.L.L.C.

Practice address

21610 E 11 Mile Rd
Saint Clair Shores, MI 48081-1671

Phone

(586) 913-1530

NPI assigned

Sep 12, 2018

Organization subpart

No

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

Authorized official

Name

Carissa GluthNPI 1588912406

Title

Founder / Therapist

Phone

(586) 913-1530

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carissa Gluth, LLMSW

  • Social Worker
  • Saint Clair Shores, MI
  • NPI 1588912406
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1881177236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21610 E 11 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811671",
            "telephone_number": "586-913-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21610 E 11 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811671",
            "telephone_number": "586-913-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED OAK COUNSELING, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-12",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "GLUTH",
        "authorized_official_first_name": "CARISSA",
        "authorized_official_title_or_position": "FOUNDER / THERAPIST",
        "authorized_official_telephone_number": "586-913-1530"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mistie D Ryan
• Miranda Rysiewicz, PT, DPT
• Richard T Saady, LMT
• Davis Brian Sabo
• Sacred Heart Rehabilitation Center, Inc.
• Moutamn Sadoun, M.D.
• Erica Sagese
• David James Saglimbene, D.D.S.
• Mohammed Sahly, MD
• Sailaja Datla MD PLC

• Clinical Social Worker in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.