Individual provider Active NPI

Kayla Pacic, MA

  • Professional Counselor
  • Saint Clair Shores, MI
National Provider Identifier
1073169553
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
23100 Jefferson Ave
Saint Clair Shores, MI 48080-2756
Phone
(586) 335-2006
NPI assigned
Aug 12, 2019
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

23100 Jefferson Ave
Saint Clair Shores, MI 48080-2756

Mailing address

4341 Summerlane Ave NE
Grand Rapids, MI 49525-9507
Phone (616) 558-6837

Other practice location 1

3501 Lake Eastbrook Blvd SE Ste 120
Grand Rapids, MI 49546-5939
Phone (313) 403-8464

Other names 1

  • Kayla Schramski Former name

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
I20241009003118 MI Practitioner - Mental Health Counselor 6608307079 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Kayla Pacic Counseling Services, PLLC Professional Current Accepting new patients
On Earth Project CurrentSince Jul 11, 2024 Accepting new patients

Locations

3501 Lake Eastbrook Blvd SE
Ste 120
Grand Rapids, MI 49546
Phone (206) 696-8765

4081 Cascade Rd SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 319-1978

34441 8 Mile Rd
Ste 116
Livonia, MI 48152
Phone (248) 615-1533

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1073169553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4341 SUMMERLANE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259507",
            "telephone_number": "616-558-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 JEFFERSON AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802756",
            "telephone_number": "586-335-2006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Lake Eastbrook Blvd SE Ste 120",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495465939",
            "country_code": "US",
            "telephone_number": "313-403-8464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACIC",
        "first_name": "KAYLA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "SCHRAMSKI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.