NPIMap

Organization Active NPI

Bay Area Counseling, LLC

  • Psychologist
  • Traverse City, MI
National Provider Identifier
1902947088
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
BAY AREA COUNSELING, LLC
Practice address
3180 Racquet Club Dr
Traverse City, MI 49684-4797
Phone
(231) 933-4009
Fax
(231) 933-4032
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Kimberly Kelly, PSYDNPI 1447479290
Title
Psychologist/ Owner
Phone
(231) 933-4009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

3180 Racquet Club Dr
Traverse City, MI 49684-4797

Mailing address

PO Box 2257
Chesterton, IN 46304-0357
Phone (219) 926-8320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090812000245 MI Part B Supplier - Clinic/Group Practice 2466440383 Receives reassigned benefits from 3 practitioners
Practice locations: Traverse City, MI

National Provider Directory

National Provider Directory

Locations

2226 S Airport Rd W
Ste C
Traverse City, MI 49684
Phone (231) 933-4009

3180 Racquet Club Dr
Ste G
Traverse City, MI 49684
Phone (231) 922-2885

3180 Racquet Club Dr
Traverse City, MI 49684
Phone (231) 933-4009

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1902947088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357",
            "telephone_number": "219-926-8320",
            "fax_number": "219-926-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 RACQUET CLUB DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844797",
            "telephone_number": "231-933-4009",
            "fax_number": "231-933-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PSYCHOLOGIST/ OWNER",
        "authorized_official_telephone_number": "231-933-4009",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.