Jasmine Koussa, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401226255 Issued in MI

Practice address

47818 Van Dyke Ave
Shelby TWP, MI 48317-3373

Phone

(586) 323-3620

NPI assigned

Jan 23, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Mental Health Counselor

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Clementine Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shelby TWP, MI
  • NPI 1265360739
  NPD Authorized official
• Lyon Counseling Center

  • Adult Mental Health Clinic/Center
  • South Lyon, MI
  • NPI 1457983355
  NPD
• United Psychological Services Inc

  • Clinical Neuropsychologist
  • Shelby TWP, MI
  • NPI 1407947658
  NPD (past)

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1710748017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47818 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483173373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47818 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483173373",
            "telephone_number": "586-323-3620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 N Lafayette St",
            "address_purpose": "LOCATION",
            "city": "South Lyon",
            "state": "MI",
            "postal_code": "481781210",
            "country_code": "US",
            "telephone_number": "248-573-7417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUSSA",
        "first_name": "JASMINE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401226255",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401226255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atheel Kinaia
• Kimberly Sue Klimek, PT
• Marcia Elizabeth Kling, M.D.
• Jennifer L Knaack, CMT
• Komraus Compassionate Counseling PLLC
• Jacqueline Kromer
• KSS of Shelby LLC
• Puja Kumari, PTA
• Konnor Kuppe
• L Van Ameyde DDS, PC

• Professional Counselor in Shelby TWP, MI
• Providers in Shelby TWP, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.