Individual provider Active NPI

Alicia Kleyn, LLP

  • Counseling Psychologist
  • Ludington, MI
National Provider Identifier
1215396015
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6301016409 Issued in MI
Practice address
920 Diana St
Ludington, MI 49431-1987
Phone
(231) 845-6294
Fax
(231) 845-7095
NPI assigned
Feb 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6301016409 MI Primary

Addresses

Primary practice location

920 Diana St
Ludington, MI 49431-1987

Mailing address

920 Diana St
Ludington, MI 49431-1987
Phone (231) 845-6294

Other practice location 1

600 S Beacon Blvd
Grand Haven, MI 49417-2178
Phone (616) 805-3660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6301016409MIMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC PastSince Dec 1, 2019 Accepting new patients

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": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1215396015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DIANA ST",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311987",
            "telephone_number": "231-845-6294",
            "fax_number": "231-845-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DIANA ST",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311987",
            "telephone_number": "231-845-6294",
            "fax_number": "231-845-7095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S Beacon Blvd",
            "address_purpose": "LOCATION",
            "city": "Grand Haven",
            "state": "MI",
            "postal_code": "494172178",
            "country_code": "US",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEYN",
        "first_name": "ALICIA",
        "credential": "LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301016409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.