Katie Jean Proctor, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6801112220 Issued in MI

Practice address

1537 Hidden Creek Circle Dr NE Apt a
Grand Rapids, MI 49505-5485

Phone

(734) 564-1259

NPI assigned

May 16, 2023

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

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.

• Coastal Winds Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Livonia, MI
  • NPI 1225997976
  NPD Authorized official

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1295426773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1537 HIDDEN CREEK CIRCLE DR NE APT A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055485",
            "telephone_number": "734-564-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 HIDDEN CREEK CIRCLE DR NE APT A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055485",
            "telephone_number": "734-564-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "KATIE",
        "middle_name": "JEAN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801112220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Sue Prinsmorofsky
• Nichole Lynn Prior, LMSW
• Veronica Pritchard, DO
• Private Healthcare Facilities
• Dominika Proctor
• Kimberly Proctor, LLMSW
• Madison Proctor
• Professional Dentalcare Associates, PLLC
• Professional Experienced Assistant Caring for the Elderly of Mind
• Professional Eyecare of West Michigan LLC

• Mental Health Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.