Individual provider Active NPI

Kailah Rayne Ayres-Tuttle, MA, LPC

  • Professional Counselor
  • Ann Arbor, MI
National Provider Identifier
1366912768
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401019182 Issued in MI
Practice address
1601 Briarwood Cir Ste 400
Ann Arbor, MI 48108-1650
Phone
(734) 822-4971
NPI assigned
Nov 28, 2018
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401019182 MI Primary

Addresses

Primary practice location

1601 Briarwood Cir Ste 400
Ann Arbor, MI 48108-1650

Mailing address

1601 Briarwood Cir Ste 400
Ann Arbor, MI 48108-1650
Phone (734) 822-4971

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
I20240411002474 MI Practitioner - Mental Health Counselor 3375982291 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emh A2 CD, LLC CurrentSince Mar 6, 2024 Accepting new patients
Emh Birmingham-Bloomfield-Troy LLC PastSince Feb 1, 2023 Accepting new patients

Locations

1601 Briarwood Cir
Ste 400
Ann Arbor, MI 48108
Phone (734) 822-4971

1785 W Stadium Blvd
Ste 203
Ann Arbor, MI 48103
Phone (734) 212-2872

1785 W Stadium Blvd
Ste 203A
Ann Arbor, MI 48103
Phone (734) 212-2872

36400 Woodward Ave
Ste 222
Bloomfield Hills, MI 48304
Phone (248) 629-2799

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1366912768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BRIARWOOD CIR STE 400",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081650",
            "telephone_number": "734-822-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRIARWOOD CIR STE 400",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081650",
            "telephone_number": "734-822-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYRES-TUTTLE",
        "first_name": "KAILAH",
        "middle_name": "RAYNE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2024-01-10",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401019182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.