Individual provider Active NPI

Robert Joseph Kaiser Jr., LPC

  • Professional Counselor
  • Saint Clair Shores, MI
National Provider Identifier
1649742792
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401019644 Issued in MI
Practice address
22708 Harper Ave
Saint Clair Shores, MI 48080-1823
Phone
(586) 445-2210
Fax
(586) 445-0070
NPI assigned
Dec 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401017085 MI
Professional Counselor 101YP2500X 6401019644 MI Primary

Addresses

Primary practice location

22708 Harper Ave
Saint Clair Shores, MI 48080-1823

Mailing address

20643 Maple LN
Grosse Pointe Woods, MI 48236-1523
Phone (313) 671-9689

Other practice location 1

29451 Greenfield Rd
Southfield, MI 48076-2251
Phone (248) 864-5200

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401017085MIMDCounselor
6401019644MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Eastwood Behavioral Health PastSince Jan 1, 2024 Accepting new patients
Henry Ford Health Eastwood Behavioral Health Counselor PastSince Feb 19, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1649742792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20643 MAPLE LN",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361523",
            "telephone_number": "313-671-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22708 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801823",
            "telephone_number": "586-445-2210",
            "fax_number": "586-445-0070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29451 Greenfield Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480762251",
            "country_code": "US",
            "telephone_number": "248-864-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAISER",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-28",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401017085",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401019644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.