MRS. KATHLEEN MARIE WELLER (LCPC) – Mental Health Counselor, NPI 1073665311

MRS. KATHLEEN MARIE WELLER (LCPC) is a healthcare provider. based in Grand rapids, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LCPC. They hold a License No. 6401011108 (MI). The NPI Number for MRS. KATHLEEN MARIE WELLER (LCPC) is 1073665311

Main info

Female
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KATHLEEN MARIE WELLER (LCPC)
NPI
1073665311
Phone
(616) 747-0700
Address
1550 E BELTLINE AVE SE STE 255
Enumeration Date
17 January 2007
Last Update Date
24 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6167670700
Graduation Year
1998 (28 years ago)
PAC ID
1759877608
Professional Enrollment ID
I20251231000527
Address ID
MI495064362GR1550XSEXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:19State licenses:1Digital endpointsOther names

2,308 MENTAL HEALTH COUNSELOR in IL

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Provider Addresses for MRS. KATHLEEN MARIE WELLER (LCPC)

  • 1550 E BELTLINE AVE SE STE 255

    GRAND RAPIDS, MI 495064362

    Phone: (616) 747-0700

    Type: Mailing

  • 53rd Court, Oak Lawn, Worth Township, Cook County, Illinois, 60453, United States

    OAK LAWN, IL 604532426

    Phone: (708) 423-3361

    Type: Location

  • 10259, Lindsay Lane, Mokena, Will County, Illinois, 60448, United States

    MOKENA, IL 604487997

    Phone: (708) 479-0854

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-12-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251231000527IMental Health CounselorMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49506)

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Reviews

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Frequently asked questions

Does MRS. KATHLEEN MARIE WELLER (LCPC) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MRS. KATHLEEN MARIE WELLER (LCPC) uses 1073665311.
Is MRS. KATHLEEN MARIE WELLER (LCPC) listed as active for patients and plans?
The listing shows MRS. KATHLEEN MARIE WELLER (LCPC) as active in the NPI system.
What is MRS. KATHLEEN MARIE WELLER (LCPC) best known for clinically?
Directory data describes MRS. KATHLEEN MARIE WELLER (LCPC) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What address line appears for MRS. KATHLEEN MARIE WELLER (LCPC)?
MRS. KATHLEEN MARIE WELLER (LCPC)'s geographic hint is Grand Rapids, Michigan in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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