Active NPI
Kathryn Mary Thompson, LPC, CADC, NCC, ACS
- Professional Counselor
- Southgate, MI
National Provider Identifier
1174856975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401011809
- Practice address
- 1 Heritage Dr Ste 261
Southgate, MI 48195-2574 - Phone
- (734) 778-0663
- NPI assigned
- Sep 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401011809 | MI | Primary |
Addresses
Primary practice location
1 Heritage Dr Ste 261
Southgate, MI 48195-2574
Mailing address
1 Heritage Dr Ste 261
Southgate, MI 48195-2574
Phone (734) 778-0663
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Heritage Dr
Suite 261
Southgate, MI 48195-2574
Phone (734) 778-0663
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401011809 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellness Counseling L.L.C. | Professional | Current | Accepting new patients |
Locations
1 Heritage Dr
Ste 261
Southgate, MI 48195
Phone (734) 778-0663
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": "1252540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693785600000",
"number": "1174856975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HERITAGE DR STE 261",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952574",
"telephone_number": "734-778-0663",
"fax_number": "734-785-8328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HERITAGE DR STE 261",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952574",
"telephone_number": "734-778-0663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "KATHRYN",
"middle_name": "MARY",
"name_prefix": "Mrs.",
"credential": "LPC, CADC, NCC, ACS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-10",
"last_updated": "2023-09-04",
"certification_date": "2023-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401011809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.