Alyssa Dantzer, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851114768 Issued in MI

Practice address

655 E Cedar Ave
Gladwin, MI 48624-2215

Phone

(989) 426-9295

NPI assigned

Apr 11, 2019

Reactivated

Jun 12, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Enhanced Behavioral Respite Inc.

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Saginaw, MI
  • NPI 1619503356
  NPD
• ABA Pathways, LLC

  • Behavior Analyst
  • Ann Arbor, MI
  • NPI 1770838468
  NPD (past)

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1962965475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 663",
            "city": "LAKELAND",
            "state": "MI",
            "postal_code": "481430663",
            "telephone_number": "810-599-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486242215",
            "telephone_number": "989-426-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTZER",
        "first_name": "ALYSSA",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "deactivation_date": "2023-03-14",
        "reactivation_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851114768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Crandall
• Kenneth C Crawford
• Crossroads Psychological Center PLLC
• Janice May Crowley, LMSW
• Erykah Rielly Curns
• Shannon Davidson, CPRC, CPSS
• Neddine M Demory, MA, LPC, QMHP, CAADC
• Chelsea Desloover, L.P.N
• Mikala Devine
• Erika Dianis, PSYD

• Clinical Social Worker in Gladwin, MI
• Providers in Gladwin, 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 Jun 12, 2023; 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.