Individual provider Active NPI

Keith Hewitt Jr., L.L.P.C.

  • Professional Counselor
  • Kalamazoo, MI
National Provider Identifier
1912459504
Registry record updated Oct 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401015748 Issued in MI
Practice address
5568 Susan Ave
Kalamazoo, MI 49048-5820
Phone
(269) 267-6565
NPI assigned
Oct 29, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401015748 MI Primary

Addresses

Primary practice location

5568 Susan Ave
Kalamazoo, MI 49048-5820

Mailing address

5568 Susan Ave
Kalamazoo, MI 49048-5820
Phone (269) 267-6565

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240422000986 MI Practitioner - Mental Health Counselor 3678912888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restorative Therapy and Counseling ServicesGroup PAC ID 5193114635, 13 clinicians

Practice addresses (Care Compare)

246 E Kilgore Rd
Portage, MI 49002-0507
Phone (269) 249-7179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401015748MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Restorative Therapy & Counseling Services CurrentSince Mar 17, 2024 Accepting new patients

Locations

800 E Milham Ave
Portage, MI 49002
Phone (269) 249-7179

800 E Milham Ave
Ste 200
Portage, MI 49002
Phone (269) 249-7179

246 E Kilgore Rd
Portage, MI 49002
Phone (269) 249-7179

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": "1477699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477699200000",
    "number": "1912459504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5568 SUSAN AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490485820",
            "telephone_number": "269-267-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5568 SUSAN AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490485820",
            "telephone_number": "269-267-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEWITT",
        "first_name": "KEITH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "L.L.P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-29",
        "last_updated": "2016-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401015748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.