Individual provider Active NPI

Ian Kubiak

  • Professional Counselor
  • East Lansing, MI
National Provider Identifier
1790028330
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401224637 Issued in MI
Practice address
2970 E Lake Lansing Rd
East Lansing, MI 48823-7415
Phone
(517) 230-5695
NPI assigned
Apr 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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 6401224637 MI Primary

Addresses

Primary practice location

2970 E Lake Lansing Rd
East Lansing, MI 48823-7415

Mailing address

812 E Jolly Rd
Suite 210
Lansing, MI 48910-6818
Phone (517) 346-8200

Other practice location 1

201 W Railroad St Ste A
Saint Johns, MI 48879-1513
Phone (989) 224-6729

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260223001446 MI Practitioner - Mental Health Counselor 1951882505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

812 E Jolly Rd
Suite 210
Lansing, MI 48910-6821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401224637MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health Authority of Clinton Eaton Ingham Counties CurrentSince Jan 3, 2026 Accepting new patients
Genoa Healthcare LLC Past Accepting new patients

Locations

228 S Cochran Ave
Charlotte, MI 48813
Phone (517) 543-5100

812 E Jolly Rd
Lansing, MI 48910
Phone (517) 237-7162

812 E Jolly Rd
Ste 216
Lansing, MI 48910
Phone (517) 346-9525

812 E Jolly Rd
Ste 210
Lansing, MI 48910
Phone (517) 237-7162

606 W Shiawassee St
Lansing, MI 48933
Phone (517) 371-2077

201 W Railroad St
Ste A
Saint Johns, MI 48879
Phone (989) 224-5300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1790028330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD",
            "address_2": "SUITE 210",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106818",
            "telephone_number": "517-346-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 E LAKE LANSING RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488237415",
            "telephone_number": "517-230-5695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 W Railroad St Ste A",
            "address_purpose": "LOCATION",
            "city": "Saint Johns",
            "state": "MI",
            "postal_code": "488791513",
            "country_code": "US",
            "telephone_number": "989-224-6729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBIAK",
        "first_name": "IAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-02",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401224637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.