Kelly C Harris

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401222346 Issued in MI

Practice address

9735 Horseshoe BND
Dexter, MI 48130-9532

Phone

(734) 358-0179

NPI assigned

Jan 29, 2022

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

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

Medicare enrollment (NPD)

Enrolled

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.

• Ypsi Arbor Counseling, LLC

  • Clinical Social Worker
  • Ann Arbor, MI
  • NPI 1396315305
  Medicare reassignment NPD

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

{
    "created_epoch": "1643414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643414400000",
    "number": "1376296418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 HORSESHOE BND",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481309532",
            "telephone_number": "734-358-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 HORSESHOE BND",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481309532",
            "telephone_number": "734-358-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KELLY",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-29",
        "last_updated": "2022-01-29",
        "certification_date": "2022-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401222346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Grisham, RN
• Leela Mirafzali Hamp, MD
• Natalie Jane Harkness
• Kathryn Mary Jordan Harmes, M.D.
• Diane Medved Harper, M.D.
• Deborah R Hart, RDN
• Denis Brian Hart, M.D.
• Jodie Hastings, MS CCC-SLP
• Sydney Liedel Hattie, NP
• Healthy Smiles Dental Care of Dexter

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.