Individual provider Active NPI

Kinsey Harrison, MS, CCC-SLP

  • Speech-Language Pathologist
  • Benton Harbor, MI
National Provider Identifier
1104487198
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1651 E Nickerson Ave
Benton Harbor, MI 49022-2469
Phone
(269) 983-5833
NPI assigned
Jun 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X MI Primary

Addresses

Primary practice location

1651 E Nickerson Ave
Benton Harbor, MI 49022-2469

Mailing address

1651 E Nickerson Ave
Benton Harbor, MI 49022-2469
Phone (269) 983-5833

Other names 1

  • Kinsey Hill Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190702003061 MI Practitioner - Qualified Speech Language Pathologist 3779817291 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rise Therapy & Wellness LLC CurrentSince Feb 10, 2026 Accepting new patients

Locations

8599 N 32nd St
Ste 104
Richland, MI 49083
Phone (269) 203-7394

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": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1104487198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 E NICKERSON AVE",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222469",
            "telephone_number": "269-983-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 E NICKERSON AVE",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222469",
            "telephone_number": "269-983-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "KINSEY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-21",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KINSEY",
            "last_name": "HILL",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Benton Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.