Kim Beth Ketola, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801066233 Issued in MI

Practice address

39520 Woodward Ave
Suite 233
Bloomfield Hills, MI 48304-5054

Phone

(586) 216-4553

NPI assigned

Oct 19, 2006

Last updated

Mar 28, 2011By the provider in NPPES

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 identifiers 1

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

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• KBK Counseling Services, P.C.

  • Clinical Social Worker
  • Bloomfield Hills, MI
  • NPI 1295024487
  Medicare reassignment Authorized official
• St. Joseph Mercy Hospital Crna Group

  • Certified Registered Nurse Anesthetist
  • Pontiac, MI
  • NPI 1568493047
  NPD (past)
• Young H. Kim, MD, PC

  dba Clarkston Family Counseling Associates

  • Psychiatry Physician
  • Auburn Hills, MI
  • NPI 1033263678

  Clinical

  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1326129750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5316 BREEZE HILL PL",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982725",
            "telephone_number": "586-216-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39520 WOODWARD AVE",
            "address_2": "SUITE 233",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045054",
            "telephone_number": "586-216-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETOLA",
        "first_name": "KIM",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801066233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0899799",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maureen A Kelly, MD
• Sheila Lorraine Kendrick
• Janet Kennedy
• Keri Topouzian, D.O., P.C.
• Allison Brooke Kerns
• Jeffrey Avedis Kezlarian, MD
• Natalia Khalil, DDS
• Shaher W Khan, MD
• Thamreen Siddiqui Khan, LMSW
• Zohra Jabein Khan

• Clinical Social Worker in Bloomfield Hills, MI
• Providers in Bloomfield Hills, 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 Mar 28, 2011; 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.