Karen Alyse Waldrop, LPC

Key facts

NPI

1154776003

Entity type

Individual (NPI type 1)

Primary specialty

Professional Counselor 101YP2500X

License

6401006035 (MI)

Practice address

31815 Southfield Rd Ste 18
Beverly Hills, MI 48025-5471

Phone

(248) 480-0115

Fax

(248) 282-7114

NPI assigned

Apr 28, 2016

Sex

Female

Sole proprietor

No

Organizations & group practices 3

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.

• Mas Counseling Services, PLLC Mental Health Clinic/Center (Including Community Mental Health Center) · Beverly Hills, MI · NPI 1912309352
  NPD PROFESSIONAL
• A Better Tomorrow Counseling and Consultation Services, LLC Mental Health Counselor · Redford, MI · NPI 1962763052
  NPD (past)
• Thomas Park M.D. PC Preferred Provider Organization · Southfield, MI · NPI 1881904605
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• Karen Alyse Gach Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 1, 2021.

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1154776003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31815 SOUTHFIELD RD STE 18",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255471",
            "telephone_number": "248-480-0115",
            "fax_number": "248-282-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31815 SOUTHFIELD RD STE 18",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255471",
            "telephone_number": "248-480-0115",
            "fax_number": "248-282-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDROP",
        "first_name": "KAREN",
        "middle_name": "ALYSE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401006035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154776003",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "GACH",
            "middle_name": "ALYSE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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