Renegade Counseling

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

RENEGADE COUNSELING

Practice address

5303 Old County Rd 611
Kingsley, MI 49649-9246

Phone

(231) 429-8396

NPI assigned

Dec 6, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shea Stokes, LPCNPI 1487306783

Title

Mental Health Counselor

Phone

(231) 429-8396

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shea Stokes

  • Counselor
  • Traverse City, MI
  • NPI 1487306783

  Professional

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1013723725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5303 OLD COUNTY RD 611",
            "city": "KINGSLEY",
            "state": "MI",
            "postal_code": "496499246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303 OLD COUNTY RD 611",
            "city": "KINGSLEY",
            "state": "MI",
            "postal_code": "496499246",
            "telephone_number": "231-429-8396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEGADE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "SHEA",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "231-429-8396",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lars Mitchell, MPT OCS CSCS
• Shannon Christine Nemeth, M.S., PT
• Eric David Newberry, DPT
• Northland Food Center Inc
• Angel Rae Oster
• RNC Medical Supplies
• Ben C Shembarger
• Cameron Gregory Sipple
• Kathryn Elaine Smith, PHARMD
• Kari Jo Speckman, MS PT CMLDT

• Professional Counselor in Kingsley, MI
• Providers in Kingsley, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.