SAMARITAS LUTHERAN SOCIAL SERVICES OF MICHIGAN – Addiction (Substance Use Disorder) Counselor, NPI 1972860005
Addiction (Substance Use Disorder) Counselor
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SAMARITAS LUTHERAN SOCIAL SERVICES OF MICHIGAN
128 S COCHRAN AVE
CHARLOTTE, MI 488131510
Phone: (517) 325-9090
Fax: (517) 325-9091
Type: Location
1803 Whites Rd
Suite 5
Kalamazoo, MI 490082883
Phone: (269) 345-5776
Fax: (269) 345-4011
Type: Location
2450 Van Ommen Dr
Holland, MI 494248085
Phone: (616) 516-9985
Type: Location
524 Washington Ave
Grand Haven, MI 494171455
Phone: (616) 516-9985
Type: Location
8131 E JEFFERSON AVE
DETROIT, MI 482142610
Phone: (269) 345-5776
Fax: (269) 345-4011
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-03-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-03-31 (72 days ago).
Enrollment records
1
Earliest due date
2026-03-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20210324001690 | O | Clinic/Group Practice | MI | 2026-03-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48813)
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