Sarah E.W. Koon, LMHC, LCAC, LPC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6401016578 Issued in MI

Practice address

805 Leonard St NE
Grand Rapids, MI 49503-1138

Phone

(616) 451-2021

NPI assigned

Oct 4, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

Electronic endpoints 1

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, 2012

Medicare assignment

May accept Medicare assignment

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 and National Provider Directory roles.

• Kent County CMH Authority

  dba Network 180

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1588935068
  Medicare reassignment NPD
• D a Blodgett-St Johns

  dba D.A. Blodgett For Children

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1801929435
  NPD
• Kent County CMH Authority

  dba Network 180

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1194617811
  NPD
• D.a. Blodgett - St. John's

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1861701229
  NPD (past)
• Whitington Homes & Services for Children and Families, Inc

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1982912739
  NPD (past)

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1811249691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ROLLINGROCK DR",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411197",
            "telephone_number": "517-448-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031138",
            "telephone_number": "616-451-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2423 Fairfield Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468071210",
            "country_code": "US",
            "telephone_number": "260-745-9431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOON",
        "first_name": "SARAH",
        "middle_name": "E.W.",
        "name_prefix": "Mrs.",
        "credential": "LMHC, LCAC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A9927",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A9927",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6401016578",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001563A",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "3072-A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000000",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "GrandRapids",
            "affiliation": "N",
            "address_1": "805 Leonard St NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495031138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kool Counseling, LLC
• Lucas Koole, LPC
• Philip Marinus Koole, LLMSW
• Kadie Ann Koolwick, DDS
• Eugene Martin Koon, LBSW
• Stormie Koon
• Jonathan William Koons, MD
• Erin Kavanagh Koontz, PA-C
• April Christine Koop, LLMSW
• Alyssa Koopman, RDN

• Counseling Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Counseling Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.