Individual provider Active NPI

Kelsy D Hoerauf, LMFT

  • Marriage & Family Therapist
  • Fenton, MI
National Provider Identifier
1235430802
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4101006471 Issued in MI
Practice address
4031 Owen Rd
Fenton, MI 48430-9100
Phone
(810) 730-5444
NPI assigned
Nov 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Marriage & Family Therapist 106H00000X 4101006471 MI Primary

Addresses

Primary practice location

4031 Owen Rd
Fenton, MI 48430-9100

Mailing address

4031 Owen Rd
Fenton, MI 48430-9100
Phone (810) 730-5444

Other names 1

  • Kelsy D Anderson Former name

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
I20240517002227 MI Practitioner - Marriage and Family Therapist 9739520933 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4101006471MIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC CurrentSince Apr 5, 2025 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Apr 5, 2025 Accepting new patients
Kelsy Hoerauf PC Marriage & Family Therapist PastSince Mar 11, 2025 Accepting new patients

Locations

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

1100 Torrey Rd
Ste 100
Fenton, MI 48430
Phone 8104947180106

Organizations & group practices 3

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": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1235430802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 OWEN RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309100",
            "telephone_number": "810-730-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 OWEN RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309100",
            "telephone_number": "810-730-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOERAUF",
        "first_name": "KELSY",
        "middle_name": "D",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-12",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSY",
            "last_name": "ANDERSON",
            "middle_name": "D",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.