Sandy Shores Behavioral Health Services, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SANDY SHORES BEHAVIORAL HEALTH SERVICES, PLLC

Practice address

220 W Washington St Ste 130
Marquette, MI 49855-4359

Phone

(906) 266-0200

NPI assigned

Dec 21, 2023

Last updated

Dec 21, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Heather Busser-Demarte, PSYDNPI 1497034375

Title

Owner

Phone

(312) 513-8627

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, and the practitioner matching its NPPES authorized official.

• Heather Busser-Demarte, PSYD

  • Clinical Psychologist
  • Marquette, MI
  • NPI 1497034375
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1922877638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 AUTUMN TRL",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498559070",
            "telephone_number": "312-513-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W WASHINGTON ST STE 130",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554359",
            "telephone_number": "906-266-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDY SHORES BEHAVIORAL HEALTH SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "BUSSER-DEMARTE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-513-8627",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samone Derks LLC
• Michael Sanders
• Steven Garfirld Sanderson, DC
• Thomas Scott Sandin, P.A.-C.
• Danielle Sandstrom, NP
• Sarah Catherine Santiago, LPC
• Laura Santoro, M.D.
• Mark Sarazin, MD
• Ramakrishnan Sasi, PHD
• Scott K Sather, OD

• Clinical Psychologist in Marquette, MI
• Providers in Marquette, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.