Individual provider Active NPI

Esmeralda Marin Gallegos, MA LPC

  • Counselor
  • Kalamazoo, MI
National Provider Identifier
1275067167
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401017532 Issued in MI
Practice address
2001 Hudson Ave Ste D
Kalamazoo, MI 49008-1889
Phone
(989) 906-3171
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401017532 MI Primary

Addresses

Primary practice location

2001 Hudson Ave Ste D
Kalamazoo, MI 49008-1889

Mailing address

2001 Hudson Ave Ste D
Kalamazoo, MI 49008-1889
Phone (989) 906-3171

Other names 1

  • Ms. Esmeralda Marin Gallegos Professional 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
I20231219003040 MI Practitioner - Mental Health Counselor 3870943756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kalamazoo County Community Mental Health AuthorityGroup PAC ID 5890730337, 38 clinicians

Practice addresses (Care Compare)

615 E Crosstown Pkwy
Kalamazoo, MI 49001-2501
Phone (269) 373-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Lilly of the Valley Counseling, LLC Counselor CurrentSince Jun 25, 2023 Accepting new patients
Kalamazoo County Community Mental Health Authority CurrentSince Jan 1, 2024 Accepting new patients
Kalamazoo County Community Mental Health Authority CurrentSince Jan 1, 2024 Accepting new patients

Locations

418 W Kalamazoo Ave
Kalamazoo, MI 49007
Phone (269) 373-6000

2001 Hudson Ave
Ste D
Kalamazoo, MI 49008
Phone (269) 371-5970

2030 Portage St
Kalamazoo, MI 49001
Phone (269) 553-7132

615 E Crosstown Pkwy
Kalamazoo, MI 49001
Phone (269) 373-6000

610 S Burdick St
Kalamazoo, MI 49007
Phone (269) 373-6000

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": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1275067167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 HUDSON AVE STE D",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081889",
            "telephone_number": "989-906-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 HUDSON AVE STE D",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081889",
            "telephone_number": "989-906-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "ESMERALDA",
        "middle_name": "MARIN",
        "name_prefix": "Ms.",
        "credential": "MA LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401017532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ESMERALDA",
            "last_name": "GALLEGOS",
            "middle_name": "MARIN",
            "prefix": "MS.",
            "credential": "MA LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.