Kourtney R Price, MA, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6451023263 Issued in MI

Practice address

1463 Beaconsfield Ave Apt 2N
Grosse Pointe Park, MI 48230-1087

Phone

(586) 359-5269

NPI assigned

Sep 18, 2023

Last updated

Sep 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Altus Home Counseling and Behavioral Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Detroit, MI
  • NPI 1477128676
  NPD (past)

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1033997549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 HAZELWOOD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482021714",
            "telephone_number": "313-319-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 BEACONSFIELD AVE APT 2N",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301087",
            "telephone_number": "586-359-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "KOURTNEY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MA, LLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451023263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Pharmacy Inc (Park Pharmacy)
• Michael J Pasqual, RPH
• Judith Carol Paul, RPH
• Bethany Anne Petrous, LLBSW
• Pointes of Care
• Pro Nurse LLC
• Pro Staff Stat LLC
• Gokulraj Ramachandran
• Rebecca Mair P C
• Kamryn Scott Richards, NONE

• Mental Health Counselor in Grosse Pointe Park, MI
• Providers in Grosse Pointe Park, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.