Individual provider Active NPI

Sara Grace Knutson, MA, LPC

  • Professional Counselor
  • Midland, MI
National Provider Identifier
1528474251
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401016122 Issued in MI
Practice address
240 W Main St Ste 2600
Midland, MI 48640-5191
Phone
(989) 906-0433
NPI assigned
Jul 2, 2014
Last updated
Nov 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401016122 MI Primary

Addresses

Primary practice location

240 W Main St Ste 2600
Midland, MI 48640-5191

Mailing address

1807 Sylvan LN
Midland, MI 48640-6760
Phone (989) 708-9564

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
I20241101001634 MI Practitioner - Mental Health Counselor 0042630816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middle Path LLCGroup PAC ID 3476930835, 4 clinicians

Practice addresses (Care Compare)

240 W Main St
Suite 1000
Midland, MI 48640-5100
Phone (989) 574-5155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401016122MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities DBT & Trauma Professional CurrentSince Aug 31, 2020 Accepting new patients
Middle Path LLC CurrentSince Sep 29, 2020 Accepting new patients
Family & Childrens Services Mid-Michigan FCSM PastSince Sep 4, 2022 Accepting new patients

Locations

240 W Main St
Ste 1000
Midland, MI 48640
Phone (989) 574-5155

240 W Main St
Ste 2600
Midland, MI 48640
Phone (989) 402-3340

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1528474251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 SYLVAN LN",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406760",
            "telephone_number": "989-708-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W MAIN ST STE 2600",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486405191",
            "telephone_number": "989-906-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "SARA",
        "middle_name": "GRACE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401016122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.