KELLY VAN MOEN MS LLPC NPI 1134571219

NPI Information

  • NPI: 1134571219
  • Provider Name: KELLY VAN MOEN, MS, LLPC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 124 W GATES ST
    SUITE 103
    BRUCE TWP, MI
    ZIP 48065
  • Phone: (586) 752-6969

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NPI Details

Kelly Van Moen, MS, LLPC is a mental health counselor in Bruce Twp, MI with 10 years of experience. Kelly Van Moen, MS, LLPC NPI is 1134571219. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

124 W GATES ST
SUITE 103
BRUCE TWP, MI
ZIP 48065-494
Phone: (586) 752-6969

The NPI 1134571219 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 7/12/2016 and was last updated on 7/12/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)6401015525MICHIGANNo
2101YM0800XCounselorMental Health6401015525MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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