Basic Information
| Provider Information | |||||||||
| NPI: | 1407230055 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAUER | ||||||||
| FirstName: | JAMIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA, LLPC, DP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8212 N JENNINGS RD | ||||||||
| Address2: | |||||||||
| City: | MOUNT MORRIS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484588248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8106875100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8212 N JENNINGS RD | ||||||||
| Address2: | |||||||||
| City: | MOUNT MORRIS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484588248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8106875100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2015 | ||||||||
| LastUpdateDate: | 04/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 6401014942 | MI | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YA0400X | MI | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.