KELLY JOAN KOUSTAS (NPI# 1528437597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528437597 |
| Entity Type | Individual |
| Full Name | KELLY JOAN KOUSTAS |
| Practice Address |
751 E Grand Blvd Detroit MI 48207-2529 |
| Mailing Address |
24616 Notre Dame Dearborn MI 48124 |
| Practice Telephone | 3139950523 |
| Mailing Telephone | 3139950523 |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2015-09-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 4703110676 | MI | Nursing Service Providers |
| Street Address |
751 E GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48207-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700984341 | Quality Behavorial Health Inc. | Substance Abuse Rehabilitation Facility | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2006-09-20 |
| 1609407311 | Marissa Osinski | Peer Specialist | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2020-01-31 |
| 1821560145 | Sheniva Sanders | Social Worker | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-12-27 |
| 1578068896 | Channell Loraine Johnson | Counselor | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-03-28 |
| 1770081242 | Joya Monnett Loray Nunn | Counselor | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-30 |
| 1699283234 | Karen Stanford | Registered Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-17 |
| 1730697830 | Jamie Wood | Registered Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-11 |
| 1790292670 | Beverly Bunton | Licensed Practical Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-02 |
| 1427564921 | Christina Byrd | Licensed Practical Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2017-12-19 |
| 1407371529 | Kymaletha Rochelle Brown | Counselor | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2017-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245848506 | Anton R Gonzales | Physical Therapy Assistant | 2295 Chene, Detroit, Mi 48207, Detroit, MI 48207 | 2020-07-22 |
| 1033733928 | Taleshia Moss | Occupational Therapist | 2295 Chene, Detroit, MI 48207 | 2020-06-05 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1649831439 | Charday Penick | Social Worker | Team Wellness, 2925 Russell St, Detroit, MI 48207 | 2019-06-24 |
| 1568023349 | Alphia Ramona Burgess | Social Worker | Team Wellness Center, 2925 Russell Street, Detroit, MI 48207 | 2019-06-24 |
| 1447741608 | Sherice Ward | Social Worker | 100 River Place Drive, Ste 250, Detroit, MI 48207 | 2018-05-23 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1043723737 | Olivia Carter | Case Management | 2712 Gratiot, Detroit, MI 48207 | 2017-11-16 |
| 1558885590 | Kalimah Johnson | Social Worker | 701 Mcdougall, Detroit, MI 48207 | 2017-08-01 |
| 1922534692 | Angela Young | Social Worker | 100 River Place 520, Detroit, MI 48207 | 2017-05-02 |
| Find all providers in zip 48207 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006538 | David Bradley | Licensed Practical Nurse | 15540 Prevost St, Detroit, MI 48227-1963 | 2020-09-01 |
| 1215540430 | Sheronda Lanetta Blackmon | Licensed Practical Nurse | 13929 Harper Ave., Detroit, MI 48213 | 2020-08-27 |
| 1518585504 | Lesley Dixon | Licensed Practical Nurse | 16668 Freeland St, Detroit, MI 48235-4500 | 2020-07-07 |
| 1720607237 | Nakesta Richardson | Licensed Practical Nurse | 9994 Bramell, Detroit, MI 48239-1304 | 2020-04-14 |
| 1962021477 | Torie Shatita Taylor | Licensed Practical Nurse | 22556 W Mcnichols Rd, Detroit, MI 48219-3140 | 2020-04-14 |
| 1689203499 | Tiffany Nicole Pierce | Licensed Practical Nurse | 8145 Greenfield Rd, Detroit, MI 48228-2220 | 2020-04-03 |
| 1750917118 | Stephanie Renee Williams | Licensed Practical Nurse | 8919 Prest St, Detroit, MI 48228-2200 | 2020-03-18 |
| 1417581299 | Valerie Adeyemi | Licensed Practical Nurse | 16559 Sorrento St, Detroit, MI 48235-4209 | 2020-03-02 |
| 1386276228 | Vikita Franklin | Licensed Practical Nurse | 16575 Snowden St, Detroit, MI 48235-4274 | 2020-02-09 |
| 1033749387 | Lachelle Mylinda Garrett | Licensed Practical Nurse | 18060 Gruebner St, Detroit, MI 48234-3854 | 2020-01-24 |
| Find all providers in DETROIT | ||||
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| 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.