Healthcare Provider Details

I. General information

NPI: 1104483262
Provider Name (Legal Business Name): LOUIS JANES SARTEN LLMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LAURA JANE SARTEN CTRS

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48578 PONTIAC TRL
WIXOM MI
48393-2554
US

IV. Provider business mailing address

48578 PONTIAC TRL
WIXOM MI
48393-2554
US

V. Phone/Fax

Practice location:
  • Phone: 248-669-5263
  • Fax:
Mailing address:
  • Phone: 248-669-5263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851117975
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: