Active NPI
Kimberly Crawford
- Professional Counselor
- Ionia, MI
National Provider Identifier
1922575372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401016388
- Practice address
- 375 Apple Tree Dr
Ionia, MI 48846-7506 - Phone
- (616) 527-1790
- NPI assigned
- Oct 24, 2018
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401016388 | MI | Primary |
Addresses
Primary practice location
375 Apple Tree Dr
Ionia, MI 48846-7506
Mailing address
375 Apple Tree Dr
Ionia, MI 48846-7506
Phone (616) 527-1790
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1715928 | Medicaid | MI |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401016388 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling Center of West Michigan, LLC | Current | Accepting new patients | |
| Virtuwell Therapy, LLC | Past | Accepting new patients |
Locations
333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005
360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021
625 Kenmoor Ave SE
Ste 215
Grand Rapids, MI 49546
65 S Main St
Ste A
Rockford, MI 49341
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.
-
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- Grand Rapids, MI
- NPI 1437610730
-
- Mental Health Counselor
- Grand Rapids, MI
- NPI 1871356212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540339200000",
"number": "1922575372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 APPLE TREE DR",
"city": "IONIA",
"state": "MI",
"postal_code": "488467506",
"telephone_number": "616-527-1790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 APPLE TREE DR",
"city": "IONIA",
"state": "MI",
"postal_code": "488467506",
"telephone_number": "616-527-1790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAWFORD",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-24",
"last_updated": "2018-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401016388",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1715928",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ionia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.