Individual provider Active NPI

Kristen Carney, LMSW

  • Mental Health Counselor
  • Southfield, MI
National Provider Identifier
1962890798
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6801093053 Issued in MI
Practice address
17320 W 12 Mile Rd
Southfield, MI 48076-2100
Phone
(248) 792-8101
NPI assigned
Jan 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6801093053 MI Primary

Addresses

Primary practice location

17320 W 12 Mile Rd
Southfield, MI 48076-2100

Mailing address

15812 Windmill Pointe Dr
Grosse Pointe Park, MI 48230-1842
Phone (313) 829-1740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801093053MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Marigold Mental Health LLC Current Accepting new patients

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": "1420070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1962890798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15812 WINDMILL POINTE DR",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301842",
            "telephone_number": "313-829-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17320 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762100",
            "telephone_number": "248-792-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEY",
        "first_name": "KRISTEN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801093053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.