Kaitlyn Nicole Gould, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6801099981 Issued in MI

Practice address

201 W Washington Ave Ste 280
Zeeland, MI 49464-1074

Phone

(616) 259-5452

NPI assigned

Nov 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaitlyn Dursema Former name

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Headwaters Counseling, LLCGroup PAC ID 8123374667, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Headwaters Counseling, LLC

  • Clinical Psychologist
  • Zeeland, MI
  • NPI 1184172272
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1477218923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W WASHINGTON AVE STE 280",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494641074",
            "telephone_number": "616-259-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W WASHINGTON AVE STE 280",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494641074",
            "telephone_number": "616-259-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "KAITLYN",
        "middle_name": "NICOLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801099981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "DURSEMA",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christian Gibson, LMSW
• Julia Gierman
• Alexa Rae-Nikkol Glazier, COTA/L
• Meagan Nicole Goldsmith, LMSW
• Sarah Wiersma Gorski, NP
• Mylee M Graham
• Emily J Grant
• Stephanie Gray, DC
• Jeffrey J. Green, P.T
• Bruce Lamoine Greenlee, PT

• Mental Health Counselor in Zeeland, MI
• Providers in Zeeland, 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 Nov 1, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.