Individual provider Active NPI

Kasey Sauder, LPC

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1124651799
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401018182 Issued in MI
Practice address
360 E Beltline Ave NE
Grand Rapids, MI 49506-1214
Phone
(616) 805-3660
NPI assigned
Feb 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401018182 MI
Professional Counselor 101YP2500X 6401018182 MI Primary

Addresses

Primary practice location

360 E Beltline Ave NE
Grand Rapids, MI 49506-1214

Mailing address

8630 Flat Creek Dr Unit J
Rockford, MI 49341-8950
Phone (989) 928-4367

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
I20231222000940 MI Practitioner - Mental Health Counselor 8224488838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

360 E Beltline Ave NE
Suite 100
Grand Rapids, MI 49506-1214
Phone (616) 805-3660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Virtuwell Therapy, LLC Mental Health PastSince Feb 4, 2024 Accepting new patients

Locations

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

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

65 S Main St
Ste A
Rockford, MI 49341

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": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1124651799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 FLAT CREEK DR UNIT J",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418950",
            "telephone_number": "989-928-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061214",
            "telephone_number": "616-805-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUDER",
        "first_name": "KASEY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-21",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401018182",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.