Stacy Jean Killian

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401017388 Issued in MI

Practice address

608 Wright Ave
Alma, MI 48801-1617

Phone

(989) 463-4140

NPI assigned

Apr 30, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1306467477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 W HUMPHREY RD",
            "city": "ITHACA",
            "state": "MI",
            "postal_code": "488479680",
            "telephone_number": "810-287-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 WRIGHT AVE",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488011617",
            "telephone_number": "989-463-4140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 S Crapo St Ste 100",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "MI",
            "postal_code": "488582941",
            "country_code": "US",
            "telephone_number": "989-772-5938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "STACY",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-30",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401017388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith G. Sikora, D.D.S.,PC
• Keith M Bever DDS Ms PC
• Kentwood Pharmacy (Kentwood Pharmacy-Alma)
• Ava Grace Kern I
• Amjad Raza Khan, DPM
• Aleigha Nicole Killingsworth
• Stanley Benjamin Kingsley, R.N.
• Marcel Kirberg
• Jeffrey B Kirby, MA LPC
• Samantha Darlene Kirk

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.