Individual provider Active NPI

Alaina C Knoedler, LPC

  • Professional Counselor
  • Portage, MI
National Provider Identifier
1164943122
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401223793 Issued in MI
Practice address
650 Trade Centre Way
Portage, MI 49002-0411
Phone
(833) 586-1113
NPI assigned
Jun 29, 2017
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X IL
Professional Counselor 101YP2500X 6401223793 MI Primary

Addresses

Primary practice location

650 Trade Centre Way
Portage, MI 49002-0411

Mailing address

68887 Blanchard St
Sturgis, MI 49091-9244
Phone (630) 200-0003

Other practice location 1

61 S Old Rand Rd
Lake Zurich, IL 60047-3127
Phone (847) 438-4222

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
I20240105001232 MI Practitioner - Mental Health Counselor 2365893153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

650 Trade Centre Way
Suite 140
Portage, MI 49002-0411
Phone (517) 882-3732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Professional CurrentSince Jan 1, 2024 Accepting new patients
Downriver Mental Health Clinic PC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

650 Trade Centre Way
Ste 140
Portage, MI 49002
Phone (269) 492-6636

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1164943122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68887 BLANCHARD ST",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "490919244",
            "telephone_number": "630-200-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 TRADE CENTRE WAY",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490020411",
            "telephone_number": "833-586-1113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61 S Old Rand Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Zurich",
            "state": "IL",
            "postal_code": "600473127",
            "country_code": "US",
            "telephone_number": "847-438-4222",
            "fax_number": "847-807-3080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNOEDLER",
        "first_name": "ALAINA",
        "middle_name": "C",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401223793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.