Individual provider Active NPI

Karl William Johnson II, MA, LPC

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1619530540
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401019152 Issued in MI
Practice address
7251 Sundale Dr SE
Grand Rapids, MI 49548-7345
Phone
(616) 893-7345
NPI assigned
Apr 16, 2019
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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 6401019152 MI Primary

Addresses

Primary practice location

7251 Sundale Dr SE
Grand Rapids, MI 49548-7345

Mailing address

7251 Sundale Dr SE
Grand Rapids, MI 49548-7345
Phone (616) 893-7345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1428 44TH St SW B
Wyoming, MI 49509-4312

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6401019152MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Recovery Service, Inc. Past Accepting new patients
Comprehensive Recovery Services, Inc. Past Accepting new patients

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, 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": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1619530540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7251 SUNDALE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495487345",
            "telephone_number": "616-893-7345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7251 SUNDALE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495487345",
            "telephone_number": "616-893-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KARL",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401019152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.