Kacie Danielle Heading, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801103431 Issued in MI

Practice address

12719 S. West Bay Shore Drive
Suite 9
Traverse City, MI 49684

Phone

(231) 943-1031

Fax

(231) 943-1032

NPI assigned

Oct 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Kacie Danielle Berthelot Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pintar Psychological Services, PC

  • Psychologist
  • Traverse City, MI
  • NPI 1023352747
  NPD (past)

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1265917686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12719 S WEST BAY SHORE DR STE 9",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845489",
            "telephone_number": "231-943-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12719 S. WEST BAY SHORE DRIVE",
            "address_2": "SUITE 9",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-943-1031",
            "fax_number": "231-943-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADING",
        "first_name": "KACIE",
        "middle_name": "DANIELLE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KACIE",
            "last_name": "BERTHELOT",
            "middle_name": "DANIELLE",
            "prefix": "MRS.",
            "credential": "LLMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Matthew Eric Hays, PA-C
• Eric Bruce Haywood, BS, CAADC
• Joan Elizabeth Hazelton, LMSW
• Benjamin Hazen, MD
• Head and Heart Therapeutic Solutions
• Kodie Heading, M.ED., BCBA, LBA
• Brenton Michael Healan, PHARMACY TECHNICIAN
• Healing Arts Counseling LLC
• Health Is Wealth Chiropractic, PLLC
• Healthquest Chiropractic, PC

• Clinical Social Worker in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.