Kathleen Cain Gedraitis, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401018450 Issued in MI

Practice address

65 S Main St Lowr Level
Rockford, MI 49341-1286

Phone

(616) 884-0895

NPI assigned

Nov 22, 2020

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

Telehealth

Offers telehealth services

Group practices

Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Counseling Center of West Michigan, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1437610730
  Medicare reassignment Care Compare group NPD
• Virtuwell Therapy, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1871356212
  NPD (past)

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

{
    "created_epoch": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1265036107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 NORTHLAND DR NE STE 100",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493417246",
            "telephone_number": "616-884-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 S MAIN ST LOWR LEVEL",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411286",
            "telephone_number": "616-884-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDRAITIS",
        "first_name": "KATHLEEN",
        "middle_name": "CAIN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-22",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David C Gabriel, O.D.
• Alexis Leigh Gallagher, DDS, MS
• Angelica Melissa Garcia-Cruces
• Gatherwell Counseling, LLC
• Maureen Mary Gaynor
• Scott E Geisel, LPC
• David George
• Nicola C. Ghareeb, P.T.
• Brittany Leanne Gibson, RBT
• Gifted Autism Services LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.