Individual provider Active NPI

Kaitlyn M Grote, LPCC

  • Professional Counselor
  • Cincinnati, OH
National Provider Identifier
1811487986
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2102555 Issued in OH
Practice address
4790 Red Bank Rd Ste 128
Cincinnati, OH 45227-1509
Phone
(513) 731-3346
NPI assigned
May 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X C.1800956-TRNE OH
Professional Counselor 101YP2500X E.2102555 OH Primary

Addresses

Primary practice location

4790 Red Bank Rd Ste 128
Cincinnati, OH 45227-1509

Mailing address

4790 Red Bank Rd Ste 128
Cincinnati, OH 45227-1509
Phone (513) 731-3346

Other identifiers 1

IdentifierTypeStateIssuer
00000OtherOHLICENSURE BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240319003468 OH Practitioner - Mental Health Counselor 1052758521 Reassigns benefits to 1 organization
I20240807004210 TX Practitioner - Mental Health Counselor 1052758521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Star Psychology and Consulting, PLLCGroup PAC ID 7012302466, 5 clinicians

Practice addresses (Care Compare)

5055 W Park Blvd
Suite 400
Plano, TX 75093-2590
Phone (940) 290-2565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.2102555OHMDProfessional Counselor
C.1800956-TRNEOHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Family Care, Inc. CurrentSince Mar 5, 2024 Accepting new patients
Blue Star Psychology & Consulting, PLLC CurrentSince Aug 16, 2024 Accepting new patients

Locations

4790 Red Bank Rd
Ste 128
Cincinnati, OH 45227
Phone (513) 252-0533

5055 W Park Blvd
Ste 400
Plano, TX 75093
Phone (901) 826-7075

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": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1811487986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 RED BANK RD STE 128",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452271509",
            "telephone_number": "513-731-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4790 RED BANK RD STE 128",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452271509",
            "telephone_number": "513-731-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTE",
        "first_name": "KAITLYN",
        "middle_name": "M",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "C.1800956-TRNE",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2102555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE BOARD",
            "identifier": "00000",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.