KAITLIN MARIE JOHANNSEN (NPI# 1356839914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356839914 |
| Entity Type | Individual |
| Full Name | KAITLIN MARIE JOHANNSEN |
| Practice Address |
300 68th St Se Grand Rapids MI 49548 |
| Mailing Address |
2611 Washington St Pella IA 50219-7924 |
| Practice Telephone | 6162816372 |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2018-08-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
090633 | IA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619370681 | Kaitlin Johannsen | Behavioral Analyst | 15373 Innovation Dr, San Diego, CA 92128-3415 | 2014-10-03 |
| Street Address |
300 68TH ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114920550 | Emergency Physicians Inc PC | General Practice | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2005-05-31 |
| 1235742768 | Robert Milton Hughes | Physician Assistant | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-08-25 |
| 1992317580 | Jacob Alan Lowe | Psychologist | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-08-17 |
| 1922619063 | Jennifer Nicole Oconnor | Social Worker | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-08-12 |
| 1407464670 | Christina Joy Weaver | Physician Assistant | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-07-14 |
| 1780200436 | Wendy Forrest | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-06-18 |
| 1003430877 | Cory Manoogian | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-06-08 |
| 1992329650 | Amy Joy Smith | Psychologist | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-05-29 |
| 1134743800 | Brendan Mcneilly | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-05-29 |
| 1467075176 | Luke Vander Wal | Psychologist | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205319811 | Pooja Patel | Social Worker | Spectrum Community Services, 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2018-09-10 |
| 1063906865 | Kimberly Eccher | Physician Assistant | 300 68th St. Se, Grand Rapids, MI 49548 | 2018-06-15 |
| 1871099481 | Baymark of Michigan, Inc. | Clinic/Center | 5500 Division Avenue Se, Kentwood, MI 49548 | 2018-04-03 |
| 1629507801 | Laura Marie Quennoz | Psychiatry & Neurology | Pine Rest Christian Mental Health Services, 300 68th Street Se, Grand Rapids, MI 49548 | 2017-06-09 |
| 1821548504 | Alison Anderson | Technician, Other | 103 Roth St Se, Grand Rapids, MI 49548 | 2016-10-06 |
| 1831540152 | Jesse Aubil | Counselor | 264 Montebello St. Se 49548, Grand Rapids, MI 49548 | 2016-06-28 |
| 1306237920 | Sarah Benton | Social Worker | 225 Colrain St Sw, 2, Grand Rapids, MI 49548 | 2015-02-18 |
| 1578996856 | Karen Marie Irving | Social Worker | 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2013-08-09 |
| 1740348044 | Robert Kenneth Richmond | Preventive Medicine | 551 36th Street. Se, Wyoming, MI 49548 | 2006-12-05 |
| 1386738953 | Sharita Montiez Hall | Social Worker | 300 68th Street Se, Grand Rapids, MI 49548 | 2006-10-03 |
| Find all providers in zip 49548 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051201 | Jennifer Joelle Jacobs | Counselor | 3760 Whispering Way Se Apt 204, Grand Rapids, MI 49546-7601 | 2020-10-22 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1528692779 | Tracy Norcross | Counselor | 2430 Camelot Ct Se, Grand Rapids, MI 49546-6001 | 2020-02-26 |
| 1487202743 | New Beginnings Counseling LLC | Counselor | 104 Ne 3rd St # 200h, Grand Rapids, MN 55744-2869 | 2019-08-29 |
| 1922652098 | Jason Powers | Counselor | 2033 43rd St Se Apt V8, Grand Rapids, MI 49508-8734 | 2019-07-28 |
| 1588225882 | Hope Restored Counseling Center LLC | Counselor | 2180 44th St Se Ste 302, Grand Rapids, MI 49508-5323 | 2019-06-26 |
| 1164089884 | Savanna Marie Vanderberg | Counselor | 1131 Worden St Se, Grand Rapids, MI 49507-1472 | 2019-05-29 |
| 1609432996 | Robb Kornoelje | Counselor | 221 Trowbridge St Ne Apt 208, Grand Rapids, MI 49503-1891 | 2019-05-13 |
| 1316423841 | Lorie Tensen | Counselor | 456 College Ave Se Apt 1, Grand Rapids, MI 49503-5373 | 2018-07-18 |
| 1548750524 | Katelyn Cable Ma LLP | Counselor | 5001 Plainfield Ave Se, Suite B, Grand Rapids, MI 49525-9349 | 2018-05-15 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49548 |
Please comment or provide details below to improve the information on KAITLIN MARIE JOHANNSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.