Organization Active NPI

Kohley Counseling LLC

  • Clinical Social Worker
  • Grandville, MI
National Provider Identifier
1518486844
Registry record updated Sep 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KOHLEY COUNSELING LLC
Practice address
2976 Ivanrest Ave SW Ste 205
Grandville, MI 49418-1440
Phone
(616) 261-0888
NPI assigned
Sep 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2017

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

Authorized official

Name
Joseph Kohley, LMSWNPI 1740338508
Title
Owner
Phone
(616) 261-0888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2976 Ivanrest Ave SW Ste 205
Grandville, MI 49418-1440

Mailing address

2723 Parkside Dr
Jenison, MI 49428-9102
Phone (616) 669-4866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200113001612 MI Part B Supplier - Clinic/Group Practice 2163857566 Receives reassigned benefits from 2 practitioners
Practice locations: Grandville, MI

National Provider Directory

National Provider Directory

Locations

2976 Ivanrest Ave SW
Ste 205
Grandville, MI 49418
Phone (616) 261-0888

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505779200000",
    "number": "1518486844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2723 PARKSIDE DR",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494289102",
            "telephone_number": "616-669-4866",
            "fax_number": "616-669-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2976 IVANREST AVE SW STE 205",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181440",
            "telephone_number": "616-261-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOHLEY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-09-19",
        "status": "A",
        "authorized_official_last_name": "KOHLEY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-261-0888",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.