Individual provider Active NPI

Kaylee Patterson, LPC

  • Counselor
  • Traverse City, MI
National Provider Identifier
1053789172
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401017892 Issued in MI
Practice address
862 E 8TH St Ste G-3
Traverse City, MI 49686-2727
Phone
(231) 642-1962
Fax
(231) 401-1055
NPI assigned
Sep 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401017892 MI
Counselor 101Y00000X 6401017892 MI Primary

Addresses

Primary practice location

862 E 8TH St Ste G-3
Traverse City, MI 49686-2727

Mailing address

611 Bates St
Traverse City, MI 49686-3308
Phone (231) 642-1962

Other practice location 1

810 Cottageview Dr Ste 101
Traverse City, MI 49684-2392
Phone (231) 642-2778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401017892MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sense of Self Counselor CurrentSince May 19, 2024 Accepting new patients

Locations

862 E Eighth St
Ste G3
Traverse City, MI 49686
Phone (231) 642-1962

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1441411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1053789172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 BATES ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863308",
            "telephone_number": "231-642-1962",
            "fax_number": "231-401-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 E 8TH ST STE G-3",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862727",
            "telephone_number": "231-642-1962",
            "fax_number": "231-401-1055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 Cottageview Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842392",
            "country_code": "US",
            "telephone_number": "231-642-2778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "KAYLEE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-05",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401017892",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401017892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.