Kristen Jeanette, DBH, MA, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401018571 Issued in MI

Practice address

3011 W Grand Blvd Ste 418
Detroit, MI 48202-3011

Phone

(248) 266-8036

NPI assigned

Nov 29, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Kristen Jeanette Kennard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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.

• Full Bloom Counseling and Consulting, PLLC

  • Professional Counselor
  • Detroit, MI
  • NPI 1407451347
  NPD

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

{
    "created_epoch": "1417219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1205233764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18497 ROSELAWN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 W GRAND BLVD STE 418",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023011",
            "telephone_number": "248-266-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANETTE",
        "first_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "DBH, MA, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-29",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018571",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "KENNARD",
            "middle_name": "JEANETTE",
            "prefix": "DR.",
            "credential": "DBH, LPC, NCC, PMH-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Jeakle, MD
• Stacy Jean-Baptiste
• Serge Jean-Louis, M.D
• Claudia Jean-Pierre
• Valerie Jean
• Benita Joshley Jebackumar, DPM
• Kim Natasha Jebodhsingh, M.D
• Maggie Jedlinsky, LLMSW
• Yoonsun Jee
• Madana Jeevanandam, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.