Healthcare Provider Details

I. General information

NPI: 1447812326
Provider Name (Legal Business Name): KRYSTEN SUGDEN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRYSTEN VELDERMAN

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5303 S CEDAR ST
LANSING MI
48911-3800
US

IV. Provider business mailing address

812 E JOLLY RD STE 210
LANSING MI
48910-6821
US

V. Phone/Fax

Practice location:
  • Phone: 517-346-8318
  • Fax:
Mailing address:
  • Phone: 517-237-7350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801104091
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: