Individual provider Active NPI

Christopher Kourtakis, LLPC

  • Professional Counselor
  • Clinton Township, MI
National Provider Identifier
1720890619
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6451024145 Issued in MI
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

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
6451024145MIMDProfessional 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.

Verify at the official NPI Registry.