Individual provider Active NPI

Gregory Scott Kaiser

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1083042881
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401012921 Issued in MI
Practice address
3424 Bonisteel NW
Grand Rapids, MI 49534-7721
Phone
(616) 560-6995
NPI assigned
Oct 15, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2013

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 6401012921 MI Primary

Addresses

Primary practice location

3424 Bonisteel NW
Grand Rapids, MI 49534-7721

Mailing address

3424 Bonisteel NW
Grand Rapids, MI 49534-7721
Phone (616) 560-6995

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
I20231219000940 MI Practitioner - Mental Health Counselor 0840640769 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherry Street Services IncGroup PAC ID 6800707647, 58 clinicians

Practice addresses (Care Compare)

100 Cherry St SE
Grand Rapids, MI 49503-4526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401012921MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry Street Services, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Counseling Center of West Michigan, LLC CurrentSince Jul 31, 2025 Accepting new patients
Cherry Street Services, Inc CurrentSince Jan 1, 2024 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

100 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 965-8209

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021

550 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 235-7272

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

4175 Parkway Place Dr SW
Ste 104
Grandville, MI 49418

4250 Chicago Dr SW
#B
Grandville, MI 49418
Phone (269) 419-2392

1611 Oak Ave
Muskegon, MI 49442
Phone (231) 724-6050

65 S Main St
Ste A
Rockford, MI 49341

Interoperability endpoints

  • Direct secure messaging: gregory.kaiser.p1@direct.cherryhealth.nextgenshare.com

Organizations & group practices 4

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": "1381795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381795200000",
    "number": "1083042881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 BONISTEEL NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495347721",
            "telephone_number": "616-560-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 BONISTEEL NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495347721",
            "telephone_number": "616-560-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-15",
        "last_updated": "2013-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401012921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.