Active NPI
Christopher Kourtakis, LLPC
- Professional Counselor
- Clinton Township, MI
National Provider Identifier
1720890619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6451024145
- Practice address
- 42815 Garfield Rd Ste 201
Clinton Township, MI 48038-1143 - Phone
- (586) 333-5328
- NPI assigned
- Jan 27, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6451024145 | MI | Primary |
Addresses
Primary practice location
42815 Garfield Rd Ste 201
Clinton Township, MI 48038-1143
Mailing address
27845 Lauren St E
Harrison Township, MI 48045-6321
Phone (248) 890-1116
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6451024145 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737936000000",
"number": "1720890619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27845 LAUREN ST E",
"city": "HARRISON TOWNSHIP",
"state": "MI",
"postal_code": "480456321",
"telephone_number": "248-890-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42815 GARFIELD RD STE 201",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480381143",
"telephone_number": "586-333-5328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOURTAKIS",
"first_name": "CHRISTOPHER",
"credential": "LLPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-27",
"last_updated": "2025-01-27",
"certification_date": "2025-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6451024145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.