Individual provider Active NPI

Andrea Morgan Kiss, CGC

  • Counselor
  • Detroit, MI
National Provider Identifier
1255009528
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
7201000209 Issued in MI
Practice address
3950 Beaubien St
Detroit, MI 48201-2166
Phone
(313) 832-9330
Fax
(313) 993-8685
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3126323
Counselor 101Y00000X 7201000209 MI Primary

Addresses

Primary practice location

3950 Beaubien St
Detroit, MI 48201-2166

Mailing address

3950 Beaubien St
Detroit, MI 48201-2166
Phone (313) 832-9330

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address AKiss@dmc.org Direct

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
7201000209MIMDCounselor

Interoperability endpoints

  • Direct secure messaging: akiss@dmc.org

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1255009528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012166",
            "telephone_number": "313-832-9330",
            "fax_number": "313-993-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012166",
            "telephone_number": "313-832-9330",
            "fax_number": "313-993-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISS",
        "first_name": "ANDREA",
        "middle_name": "MORGAN",
        "name_prefix": "Ms.",
        "credential": "CGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": "3126323",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "7201000209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AKiss@dmc.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "communication",
            "address_1": "3950 Beaubien St",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482012166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.