Kyle Boase, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401018677 Issued in MI

Practice address

6963 Marshall Ave SE
Grand Rapids, MI 49508-7438

Phone

(616) 207-4655

NPI assigned

Mar 15, 2021

Last updated

Mar 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Counseling Center of West Michigan, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1437610730
  Medicare reassignment Care Compare group NPD
• Jeanna Boase, LLC

  dba Cultivate Wellness Counseling

  • Mental Health Counselor
  • Kentwood, MI
  • NPI 1952923500
  NPD
• Virtuwell Therapy, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1871356212
  NPD (past)

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1780269357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6963 MARSHALL AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6963 MARSHALL AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087438",
            "telephone_number": "616-207-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOASE",
        "first_name": "KYLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401018677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lee Blystone, OTR/L
• Claire Elizabeth Blystra
• BMSC Mi LLC
• Michelle Lynn Boahbedason
• Board of Education Kent County
• Georgina Boateng, DO
• Clare A Bobb
• Delorrian Bobo
• Marisela Bobo, ETS, GCDF
• Holly Bobola

• Mental Health Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.