Individual provider Active NPI

Kelly Leone Collins, MA

  • Counselor
  • Grand Rapids, MI
National Provider Identifier
1891587333
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1750 Grand Ridge CT NE Ste 200
Grand Rapids, MI 49525-7043
Phone
(616) 426-9034
NPI assigned
May 20, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MI Primary

Addresses

Primary practice location

1750 Grand Ridge CT NE Ste 200
Grand Rapids, MI 49525-7043

Mailing address

2029 Bridgeport Rd NE Apt 121
Grand Rapids, MI 49505-6308
Phone (219) 921-4957

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
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Second Story Counseling II LLC Counselor CurrentSince Jun 15, 2025 Accepting new patients

Locations

1750 Grand Ridge Ct NE
Ste 200
Grand Rapids, MI 49525
Phone (616) 426-9034

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.

NPI Registry JSON

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1891587333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 BRIDGEPORT RD NE APT 121",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056308",
            "telephone_number": "219-921-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 GRAND RIDGE CT NE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257043",
            "telephone_number": "616-426-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KELLY",
        "middle_name": "LEONE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": null,
            "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 May 20, 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.

Verify at the official NPI Registry.