DR. SARAH LIETZOW WITHERELL (NPI# 1083921563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083921563 |
| Entity Type | Individual |
| Full Name | DR. SARAH LIETZOW WITHERELL |
| Other Name | MS. SARAH JANICE LIETZOW |
| Credential | PH.D., LLP |
| Practice Address |
2751 E Jefferson Ave Detroit MI 48207-4180 |
| Mailing Address |
101 E Alexandrine St Detroit MI 48201-2011 |
| Practice Telephone | 3139933434 |
| Practice Fax Number | 3139933421 |
| Mailing Telephone | 3138315535 |
| Mailing Fax Number | 3133248782 |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2014-03-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
6301015705 | MI | Behavioral Health & Social Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | MI | Student, Health Care |
| Street Address |
2751 E JEFFERSON AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48207-4180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801827746 | Psychiatry and Behaviorial Medicine Professionials | Psychiatry & Neurology | 2751 E Jefferson Ave, Detroit, MI 48207-4180 | 2006-07-06 |
| 1558604850 | Craig Vankempen | Social Worker | 2751 E Jefferson Ave, Suite 301, Detroit, MI 48207-4180 | 2013-04-04 |
| 1700134517 | Kamalika Roy | Psychiatry & Neurology | 2751 E Jefferson Ave, Detroit, MI 48207-4180 | 2012-08-28 |
| 1568710408 | Anatol Tolchinsky | Student in an Organized Health Care Education/Training Program | 2751 E Jefferson Ave, Detroit, MI 48207-4180 | 2012-08-27 |
| 1124374244 | Deepti C Challagolla | Psychiatry & Neurology | 2751 E Jefferson Ave, Detroit, MI 48207-4180 | 2012-07-26 |
| 1659650406 | Yedishtra Naidoo | Psychiatry & Neurology | 2751 E Jefferson Ave, Detroit, MI 48207-4180 | 2011-08-11 |
| 1255619896 | Sean Carlysle Prabhu | Psychiatry & Neurology | 2751 E Jefferson Ave, Detroit, MI 48207-4180 | 2011-08-01 |
| 1740568377 | Jennifer Rose Robinson | Psychiatry & Neurology | 2751 E Jefferson Ave, Detroit, MI 48207-4180 | 2011-08-01 |
| 1467730093 | Benjamin Brian Williamson | Psychiatry & Neurology | 2751 E Jefferson Ave, Detroit, MI 48207-4180 | 2011-08-01 |
| 1295966570 | Kristina Marie Levang | Psychiatry & Neurology | 2751 E Jefferson Ave, Detroit, MI 48207-4180 | 2009-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245848506 | Anton R Gonzales | Physical Therapy Assistant | 2295 Chene, Detroit, Mi 48207, Detroit, MI 48207 | 2020-07-22 |
| 1033733928 | Taleshia Moss | Occupational Therapist | 2295 Chene, Detroit, MI 48207 | 2020-06-05 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1649831439 | Charday Penick | Social Worker | Team Wellness, 2925 Russell St, Detroit, MI 48207 | 2019-06-24 |
| 1568023349 | Alphia Ramona Burgess | Social Worker | Team Wellness Center, 2925 Russell Street, Detroit, MI 48207 | 2019-06-24 |
| 1447741608 | Sherice Ward | Social Worker | 100 River Place Drive, Ste 250, Detroit, MI 48207 | 2018-05-23 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1043723737 | Olivia Carter | Case Management | 2712 Gratiot, Detroit, MI 48207 | 2017-11-16 |
| 1558885590 | Kalimah Johnson | Social Worker | 701 Mcdougall, Detroit, MI 48207 | 2017-08-01 |
| 1922534692 | Angela Young | Social Worker | 100 River Place 520, Detroit, MI 48207 | 2017-05-02 |
| Find all providers in zip 48207 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942570551 | Latanya Denise Gater | Psychologist | 15818 Tuller St, Detroit, MI 48238-1240 | 2012-01-12 |
| 1174735286 | Staci Hirsch | Psychologist | 5470 Chene Street, Detroit, MI 48211 | 2007-05-03 |
| 1780232835 | Jamie Lee Ann Douglas | Psychologist | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2019-09-02 |
| 1447731690 | Sarah Wilhoit | Psychologist | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2018-08-26 |
| 1437664786 | Laura Gilboe | Psychologist | 7310 Woodward Ave, Detroit, MI 48202-3165 | 2017-12-08 |
| 1780130278 | Jenna Jones | Psychologist | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2016-08-25 |
| 1306204847 | Chelsey Esser | Psychologist | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2016-01-28 |
| 1437529617 | Jasmine Jones | Psychologist | 15766 Whitcomb St, Detroit, MI 48227-2667 | 2015-10-01 |
| 1679950067 | Tyler Arban | Psychologist | 17321 Telegraph Rd, Detroit, MI 48219-3132 | 2015-05-05 |
| 1467872713 | Elan Dawson | Psychologist | 79 W Alexandrine St, Detroit, MI 48201-2015 | 2014-04-24 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.