Provider Demographics
NPI:1932396876
Name:SUTHERLAND, JAIME LYNN (MS, LLP, CAADC)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:LYNN
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:MS, LLP, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14800 FARMINGTON RD STE 109
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5464
Mailing Address - Country:US
Mailing Address - Phone:313-530-4656
Mailing Address - Fax:313-539-8921
Practice Address - Street 1:14800 FARMINGTON RD STE 109
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5464
Practice Address - Country:US
Practice Address - Phone:313-530-4656
Practice Address - Fax:313-539-8921
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361000780103TC0700X, 103T00000X
MIC-01630101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)