Individual provider Active NPI

Karmen Renee Earegood Taylor

  • Mental Health Counselor
  • Grandville, MI
National Provider Identifier
1407562473
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401225027 Issued in MI
Practice address
4565 Wilson Ave SW Ste 1a
Grandville, MI 49418-2371
Phone
(616) 591-9000
NPI assigned
Jan 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401225027 MI Primary

Addresses

Primary practice location

4565 Wilson Ave SW Ste 1a
Grandville, MI 49418-2371

Mailing address

4565 Wilson Ave SW Ste 1a
Grandville, MI 49418-2371
Phone (616) 591-9000

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
I20250412000070 MI Practitioner - Mental Health Counselor 4284158155 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Second Story Counseling II LLC CurrentSince Mar 17, 2025 Accepting new patients
Synergy Behavioral Health CurrentSince Jan 26, 2026 Accepting new patients

Locations

4565 Wilson Ave SW
Ste 1A
Grandville, MI 49418
Phone (616) 215-0919

3424 Chicago Dr
Ste 205
Hudsonville, MI 49426
Phone (616) 426-9034

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1407562473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4565 WILSON AVE SW STE 1A",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182371",
            "telephone_number": "616-591-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 WILSON AVE SW STE 1A",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182371",
            "telephone_number": "616-591-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KARMEN",
        "middle_name": "RENEE EAREGOOD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401225027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.