JACALYN SUE LASICH (NPI# 1487909396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487909396 |
| Entity Type | Individual |
| Full Name | JACALYN SUE LASICH |
| Credential | MSW |
| Practice Address |
217 S Madison Street Traverse City MI 49684-2320 |
| Mailing Address |
1414 W Fair Ave Ste 332 Marquette MI 49855-5407 |
| Practice Telephone | 2313928400 |
| Practice Fax Number | 2319357888 |
| Mailing Telephone | (231) 935-6080 |
| Mailing Fax Number | 2319356081 |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2018-08-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6801089753 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1487909396 | 05 | |
| MI | MICHIGAN LICENSE | 6801089753 | 01 |
| Street Address |
217 S MADISON STREET |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-2320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831180140 | David P Michelin | Obstetrics & Gynecology | 217 S Madison Street, Traverse City, MI 49684-2320 | 2005-11-04 |
| 1215308036 | Julie Comfort | Nurse Practitioner | 217 S Madison Street, Traverse City, MI 49684-3230 | 2015-10-20 |
| 1023372687 | Munson Medical Center | Internal Medicine | 217 S Madison Street, Ste 2, Traverse City, MI 49684 | 2012-06-28 |
| 1760793368 | Kristian Michael Koller | Internal Medicine | 217 S Madison Street, Traverse City, MI 49684 | 2010-06-29 |
| 1770746257 | Joshua Michael Ruch | Internal Medicine | 217 S Madison Street, Traverse City, MI 49684 | 2008-07-06 |
| 1972772259 | Kendra G Worden | Nurse Practitioner | 217 S Madison Street, Traverse City, MI 49684-2320 | 2008-02-21 |
| 1316064041 | Zachary Hector-word | Internal Medicine | 217 S Madison Street, Traverse City, MI 49684 | 2007-03-26 |
| 1356353791 | Nathan Rousse | Nurse Practitioner | 217 S Madison Street, Traverse City, MI 49684-2320 | 2006-08-13 |
| 1992749279 | Dana Lucile Hoffman | Nurse Practitioner | 217 S Madison Street, Traverse City, MI 49684-2320 | 2006-06-16 |
| 1477519940 | David S Gordon | Internal Medicine | 217 S Madison Street, Traverse City, MI 49684-2320 | 2006-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154938884 | Marlowe Mclaughlin-franklin | Social Worker | 267 Waxwing Dr, Traverse City, MI 49696-8578 | 2020-09-27 |
| 1679183784 | Full Circle Wellness Pllc | Social Worker | 13300 S West Bay Shore Dr Ste A2, Traverse City, MI 49684-5571 | 2020-08-04 |
| 1497395917 | The Resiliency Therapy Center, Pllc | Social Worker | 2113 Holland Cir, Traverse City, MI 49685-7945 | 2020-01-13 |
| 1437792892 | Jay David Tompkins | Social Worker | 333 W Grandview Pkwy Ste 403, Traverse City, MI 49684-2298 | 2019-10-17 |
| 1326500935 | Abigail A Peck | Social Worker | 2692 S M 37, Traverse City, MI 49685-9187 | 2019-04-02 |
| 1821564493 | Lauren Lee Wolf | Social Worker | 870 E 8th St, Traverse City, MI 49686-2782 | 2018-10-22 |
| 1578039673 | Nathan A Taylor | Social Worker | 812 S Garfield Ave Ste D, Traverse City, MI 49686-3456 | 2018-10-17 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1114406915 | Christina Virginia Pasternak | Social Worker | 13561 S West Bay Shore Dr Ste 201, Traverse City, MI 49684-6293 | 2018-08-13 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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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.