Active NPI
Kailie George
- Mental Health Counselor
- Grand Rapids, MI
National Provider Identifier
1790597151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A20213
- Practice address
- 155 Sweet St NE
Grand Rapids, MI 49505-4601 - Phone
- (919) 426-0270
- NPI assigned
- Jan 23, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A20213 | NC | Primary |
Addresses
Primary practice location
155 Sweet St NE
Grand Rapids, MI 49505-4601
Mailing address
3401 Deering Dr
Raleigh, NC 27616-8681
Phone (919) 426-0270
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 |
|---|---|---|---|
| A20213 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737590400000",
"number": "1790597151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 DEERING DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276168681",
"telephone_number": "919-426-0270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 SWEET ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495054601",
"telephone_number": "919-426-0270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "KAILIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-23",
"last_updated": "2025-01-23",
"certification_date": "2025-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A20213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.