# ST. JOHN HOSPITAL AND MEDICAL CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeshore Audiology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285902627
- **Authorized official:** SANDRA WHITMAN (DIRECTOR)
- **Authorized official phone:** (248) 849-4229

## Contact information

- **Practice address:** 21000 E 12 MILE RD, SUITE 111, SAINT CLAIR SHORES, MI 48081-1116
- **Practice address phone:** (586) 779-7610
- **Practice address fax:** (586) 779-1391
- **Mailing address:** 21000 E 12 MILE RD, SUITE 111, SAINT CLAIR SHORES, MI 48081-1116
- **Mailing address phone:** (586) 779-7610
- **Mailing address fax:** (586) 779-1391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | — | MI | Yes |
| 231HA2400X | Assistive Technology Practitioner Audiologist | — | MI | — |
| 231HA2500X | Assistive Technology Supplier Audiologist | — | MI | — |
| 235500000X | Speech/Language/Hearing Specialist/Technologist | — | MI | — |
| 2355A2700X | Audiology Assistant | — | MI | — |
| 2355S0801X | Speech-Language Assistant | — | MI | — |
| 235Z00000X | Speech-Language Pathologist | — | MI | — |
| 237600000X | Audiologist-Hearing Aid Fitter | — | MI | — |
| 237700000X | Hearing Instrument Specialist | — | MI | — |

## Other

- **Enumeration date:** 12/13/2011
- **Last updated:** 12/13/2011