Kelly M. Kaikkonen

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401006044 Issued in MI

Practice address

8245 Holly Rd Ste 200
Grand Blanc, MI 48439-2483

Phone

(800) 693-1916

Fax

(248) 605-3525

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1356436208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772263",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772263",
            "telephone_number": "810-441-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8245 HOLLY RD STE 200",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392483",
            "telephone_number": "800-693-1916",
            "fax_number": "248-605-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAIKKONEN",
        "first_name": "KELLY",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401006044",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301009779",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia'S Heart Home Care Agency LLC
• Majd Jundi, MD
• JWB Autism Support Services
• JWB Autism Support Services
• K.L.Williams, LLC (Toxicology-Inc)
• Mirna Kakka, PHARMD
• Kara Kalinowski
• Amy Sue Kaluza
• Guru Kandasamy, MD
• Ok Kyun Kang, M.D.

• Counselor in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.