Organization Active NPI

Katherine Kezelian, LLC

  • Clinical Social Worker
  • Royal Oak, MI
National Provider Identifier
1710598560
Registry record updated May 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KATHERINE KEZELIAN, LLC
Practice address
307 W 6TH St Ste 201
Royal Oak, MI 48067-2548
Phone
(248) 840-0595
NPI assigned
Aug 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2025

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

Authorized official

Name
Katherine Kezelian, LMSWNPI 1821383563
Title
Psychotherapist
Phone
(248) 840-0595

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

307 W 6TH St Ste 201
Royal Oak, MI 48067-2548

Mailing address

307 W 6TH St Ste 201
Royal Oak, MI 48067-2548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250716003470 MI Part B Supplier - Clinic/Group Practice 9739694803 Receives reassigned benefits from 3 practitioners
Practice locations: Royal Oak, MI

National Provider Directory

National Provider Directory

Locations

307 W 6th St
Ste 201
Royal Oak, MI 48067
Phone (248) 463-8263

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746835200000",
    "number": "1710598560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 W 6TH ST STE 201",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W 6TH ST STE 201",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672548",
            "telephone_number": "248-840-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERINE KEZELIAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-14",
        "last_updated": "2025-05-10",
        "certification_date": "2025-05-10",
        "status": "A",
        "authorized_official_last_name": "KEZELIAN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "248-840-0595",
        "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 Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2025; 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.