Kelly Aiello, LPC

Individual provider Active NPI Professional Counselor · Fort Gratiot, MI

NPI 1689016248 · NPPES record last updated Oct 10, 2016

Key facts

NPI
1689016248
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
6401013735 (MI)
Practice address
1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Phone
(810) 985-5125
Fax
(810) 985-5127
NPI assigned
Jul 24, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Water Mental Health Clinic (23 clinicians)

Practice addresses (Care Compare)

1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Phone (810) 985-5125

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241125001955 MI Practitioner - Mental Health Counselor 8820523095 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
NPI 1891833810 Professional Current
since Nov 7, 2024
Accepting new patients
Blue Water Mental Health Clinic Professional Current
since Nov 7, 2024
Accepting new patients

Locations

1501 Krafft Rd
Fort Gratiot, MI 48059
Phone (810) 985-5125

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401013735 MI Yes

Addresses

Primary practice location

1501 Krafft Rd
Fort Gratiot, MI 48059-3565

Mailing address

1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Phone (810) 985-5125

Other providers in Fort Gratiot, MI

All providers in Fort Gratiot, MI · Professional Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.