Kristy Lynn Stougaard, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401010480 Issued in MI

Practice address

300 68TH St SE
Grand Rapids, MI 49548-6927

Phone

(616) 258-7467

Fax

(616) 258-7432

NPI assigned

Oct 1, 2008

Sex

Female

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

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 and National Provider Directory roles.

• Project Rehab

  • Substance Abuse Rehabilitation Facility
  • Grand Rapids, MI
  • NPI 1104986603
  NPD (past)

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1053562736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-258-7467",
            "fax_number": "616-258-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-258-7467",
            "fax_number": "616-258-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUGAARD",
        "first_name": "KRISTY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Stornant, MA
• Jacob Kirk Stotler
• Stephanie Stott, MA, LLPC
• Gretchen Stoub
• Chantelle Tarea Stouffis, LPN
• Amanda Stout
• Daniel Simon Stout, PA-C
• Kaylynn Stout
• Kristin Marie Stout, M.D.
• Megan Stout

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.