Kelley Ann Watson, MA LLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401010926 Issued in MI

Practice address

2075 W Big Beaver Rd
Suite 520
Troy, MI 48084-3407

Phone

(248) 646-6659

NPI assigned

Feb 18, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Birmingham Maple ClinicGroup PAC ID 6800867755, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Birmingham Maple Clinic

  • Counselor
  • Troy, MI
  • NPI 1558412551
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1184863920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 W BIG BEAVER RD",
            "address_2": "SUITE 520",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843407",
            "telephone_number": "248-646-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 W BIG BEAVER RD",
            "address_2": "SUITE 520",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843407",
            "telephone_number": "248-646-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KELLEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MA LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKayla Wasilewski
• Sara Peninah Wasser, OTR/L
• Nina Wasylyn
• Alyssa Renee Waters
• Erica Watson
• Wattles RX LLC
• Waypoint Counseling Services LLC
• We Care Home Health Care Inc
• Breanne Weatherford, LLMSW
• Casey Lynn Webb, TLLP

• Professional Counselor in Troy, MI
• Providers in Troy, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.

Verify at the official NPI Registry.