Active NPI
Kiuan Jhernell Hearns, LPC
- Mental Health Counselor
- Grand Rapids, MI
National Provider Identifier
1124451141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6401018116
- Practice address
- 1560 Leonard Ave NE
Grand Rapids, MI 49505 - Phone
- (616) 456-6571
- Fax
- (616) 458-5640
- NPI assigned
- Aug 13, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6401012911 | MI | |
| Mental Health Counselor | 101YM0800X | 6401018116 | MI | Primary |
Addresses
Primary practice location
1560 Leonard Ave NE
Grand Rapids, MI 49505
Mailing address
1560 Leonard Ave NE
Grand Rapids, MI 49505
Phone (616) 456-6571
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6401012911 | MI | MD | Mental Health Counselor |
| 6401018116 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597190400000",
"number": "1124451141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 LEONARD AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49505",
"telephone_number": "616-456-6571",
"fax_number": "616-458-5640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 LEONARD AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49505",
"telephone_number": "616-456-6571",
"fax_number": "616-458-5640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEARNS",
"first_name": "KIUAN",
"middle_name": "JHERNELL",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-13",
"last_updated": "2020-08-12",
"certification_date": "2020-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6401012911",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6401018116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.