Individual provider Active NPI

Dawn Racht

  • Counselor
  • Niles, MI
National Provider Identifier
1053948919
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401018223 Issued in MI
Practice address
2527 S 11TH St Ste 2
Niles, MI 49120-4747
Phone
(269) 262-1815
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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 6401018223 MI
Counselor 101Y00000X 6401018223 MI Primary

Addresses

Primary practice location

2527 S 11TH St Ste 2
Niles, MI 49120-4747

Mailing address

2527 S 11TH St Ste 2
Niles, MI 49120-4747
Phone (269) 262-1815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240217000106 MI Practitioner - Mental Health Counselor 1254775224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401018223MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Calm Lake Counseling, PLLC Professional CurrentSince Jan 1, 2024 Accepting new patients
Midwest Recovery and Wellness LLC PastSince Mar 29, 2020 Accepting new patients

Locations

210 E Main St
Unit 71
Niles, MI 49120
Phone (269) 340-2770

Organizations & group practices 2

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1053948919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2527 S 11TH ST STE 2",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204747",
            "telephone_number": "269-262-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2527 S 11TH ST STE 2",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204747",
            "telephone_number": "269-262-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACHT",
        "first_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018223",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401018223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

Verify at the official NPI Registry.