William Blake Kooi

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401014874 Issued in MI

Legal business name

WILLIAM BLAKE KOOI

Practice address

534 Fountain St NE
Grand Rapids, MI 49503-3422

Phone

(616) 710-1504

NPI assigned

Aug 7, 2018

Organization subpart

No

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

Authorized official

Name

William Blake Kooi, LPC, NCC, QIDP

Title

Owner/Counselor

Phone

(616) 710-1504

Specialties & licenses 1

Addresses

Other names 1

• Blake Kooi Counseling Doing business as

Locations

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1720567290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 FOUNTAIN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033422",
            "telephone_number": "616-710-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 FOUNTAIN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033422",
            "telephone_number": "616-710-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM BLAKE KOOI",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "KOOI",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "616-710-1504",
        "authorized_official_credential": "LPC, NCC, QIDP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blake Kooi Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, 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 7, 2018; 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.