Active NPI
Kelly Chaiken-Crooks
- Counselor
- Detroit, MI
National Provider Identifier
1891237723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401017925
- Practice address
- 20303 Kelly Rd
Detroit, MI 48225-1206 - Phone
- (313) 245-7000
- Fax
- (313) 245-7009
- NPI assigned
- Nov 9, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401017925 | MI | Primary |
Addresses
Primary practice location
20303 Kelly Rd
Detroit, MI 48225-1206
Mailing address
20303 Kelly Rd
Detroit, MI 48225-1206
Phone (313) 245-7000
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 |
|---|---|---|---|
| 6401017925 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659657600000",
"number": "1891237723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20303 KELLY RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482251206",
"telephone_number": "313-245-7000",
"fax_number": "313-245-7009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20303 KELLY RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482251206",
"telephone_number": "313-245-7000",
"fax_number": "313-245-7009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAIKEN-CROOKS",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-09",
"last_updated": "2022-08-05",
"certification_date": "2022-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401017925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.