Dustin Raymond McKimmy, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6451023857 Issued in MI

Practice address

411 W Lake Lansing Rd Ste B110
East Lansing, MI 48823-8468

Phone

(517) 657-3533

Fax

(517) 580-0530

NPI assigned

Sep 25, 2024

Last updated

Sep 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Headspace Counseling Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lansing, MI
  • NPI 1932773918
  NPD

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1942027412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 LANSDOWN DR",
            "city": "DIMONDALE",
            "state": "MI",
            "postal_code": "488219430",
            "telephone_number": "517-899-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W LAKE LANSING RD STE B110",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238468",
            "telephone_number": "517-657-3533",
            "fax_number": "517-580-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIMMY",
        "first_name": "DUSTIN",
        "middle_name": "RAYMOND",
        "credential": "LLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451023857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian McIntyre
• Sarah McKaig, PT
• Caleb McKay
• Joyce Marlene McKenna, MSW
• Timothy Melvin McKenna, DO
• Lily McLean
• Michael Kent McLeod, M.D.
• Brian McMahon
• McNiel Family Dentistry, PC
• Nicole Marie McPharlin, NP-C

• Mental Health Counselor in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.