Individual provider Active NPI

Kathleen Piecuch, LPC

  • Professional Counselor
  • Portage, MI
National Provider Identifier
1932542313
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401013501 Issued in MI
Practice address
6070 Newport Rd
Portage, MI 49002-9234
Phone
(269) 409-3000
Fax
(269) 366-4004
NPI assigned
Apr 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 6401013501 MI
Professional Counselor 101YP2500X 6401013501 MI Primary

Addresses

Primary practice location

6070 Newport Rd
Portage, MI 49002-9234

Mailing address

6070 Newport Rd
Portage, MI 49002-9234
Phone (269) 409-3000

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
I20250123001210 MI Practitioner - Mental Health Counselor 6507302965 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401013501MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kathy Piecuch Counseling Services Counselor CurrentSince Jul 1, 2024 Accepting new patients

Locations

5380 Holiday Ter
Ste 47
Kalamazoo, MI 49009
Phone (269) 238-0222

6070 Newport Rd
Portage, MI 49002
Phone (269) 409-3000

6070 Newport Rd
Ofc A
Portage, MI 49002

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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1932542313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 NEWPORT RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490029234",
            "telephone_number": "269-409-3000",
            "fax_number": "269-366-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 NEWPORT RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490029234",
            "telephone_number": "269-409-3000",
            "fax_number": "269-366-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIECUCH",
        "first_name": "KATHLEEN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401013501",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401013501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.