Individual provider Active NPI

Kristy Eilers Rivard, LPC

  • Professional Counselor
  • Monroe, MI
National Provider Identifier
1942723952
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401009165 Issued in MI
Practice address
25 S Monroe St Ste 102
Monroe, MI 48161-2468
Phone
(734) 240-3850
Fax
(734) 240-3863
NPI assigned
Jul 21, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 6401009165 MI Primary

Addresses

Primary practice location

25 S Monroe St Ste 102
Monroe, MI 48161-2468

Mailing address

14396 Jonathon Rd
Monroe, MI 48161-9609
Phone (734) 777-3830

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
I20240416000619 MI Practitioner - Mental Health Counselor 3476992058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15479 S Telegraph Rd
Suite B
Monroe, MI 48161-8001
Phone (734) 265-0802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401009165MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Delaney Counseling Services PLLC CurrentSince May 1, 2024 Accepting new patients
K E Rivard Counseling LLC CurrentSince Mar 26, 2024 Accepting new patients
Catholic Charities of Southeast Michigan Professional Past Accepting new patients

Locations

15479 S Telegraph Rd
Ste B
Monroe, MI 48161
Phone (734) 265-0802

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1942723952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14396 JONATHON RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619609",
            "telephone_number": "734-777-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S MONROE ST STE 102",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481612468",
            "telephone_number": "734-240-3850",
            "fax_number": "734-240-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVARD",
        "first_name": "KRISTY",
        "middle_name": "EILERS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-21",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401009165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.