Thomas Koryom, LLPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401015880 Issued in MI

Practice address

1131 Ionia Ave NW
Grand Rapids, MI 49503-1020

Phone

(616) 269-7900

Fax

(616) 259-7909

NPI assigned

Feb 1, 2017

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Interact of Michigan, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kalamazoo, MI
  • NPI 1760419691
  NPD (past)

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1457899205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 IONIA AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031020",
            "telephone_number": "616-269-7900",
            "fax_number": "616-259-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 IONIA AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031020",
            "telephone_number": "616-269-7900",
            "fax_number": "616-259-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORYOM",
        "first_name": "THOMAS",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401015880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janna Kortman, CTRS
• Jodi Kortman, N.P.
• Riley Anne Kortman
• Scarlet Nicole Korvina
• Cassandra Rhunell-Jean Kory
• Dylan Lee Kosaski
• Emily Kose
• Allison J Koshen, CCC-SLP
• Stephen J Kosiara, OTR
• Mathew Kosik, LMSW, CAADC

• Mental Health Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.