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KERBY KEYLON KILLINGHAM
NPI 1750893210
Counselor - Mental Health in Grand Rapids, MI

Active since October 24, 2017
1501 WIDDICOMB AVE NW, GRAND RAPIDS, MI 49504(616) 856-0037 Get Directions Write a Review

NPPES record last updated: January 14, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 14, 2020, Nov 4, 2019, Oct 24, 2017 (3 updates tracked since 2017).

About Kerby Keylon Killingham NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KERBY KEYLON KILLINGHAM (NPI 1750893210) is an individual mental health provider in Grand Rapids, Michigan, licensed in Michigan (6401017677) and active in the NPI registry since October 2017. He maintains a secondary practice location in Grand Rapids.

NPPES Registry Identity

NPI1750893210
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameKERBY KEYLON KILLINGHAM
Location Address1501 WIDDICOMB AVE NWGrand Rapids, MI 49504-3048
Mailing Address1939 S Division AveGrand Rapids, MI 49507 · (616) 247-3815 · Fax (616) 245-0450
Phone(616) 856-0037
Sole ProprietorYes
Enumeration DateOctober 24, 2017
Last NPPES UpdateJanuary 14, 20203 updates tracked since enumeration
✔ NPI 1750893210 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MI · 6401017677
1501 WIDDICOMB AVE NW, Grand Rapids, MI 49504
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Secondary Practice Location 1

Location 11939 S Division AveGrand Rapids, MI 49507 · Phone (616) 247-3815 · Fax (616) 245-0450

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include McLaren Health Plan Community, Providence Health Plan.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kerby Killingham's NPI number?

The NPI number for Kerby Killingham is 1750893210. It was assigned to this individual provider in the NPPES registry on October 24, 2017.

Where is Kerby Killingham located?

Kerby Killingham practices at 1501 Widdicomb Ave NW, Grand Rapids, MI 49504. The listed phone number is (616) 856-0037.

What is Kerby Killingham's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

What insurance does Kerby Killingham accept?

Health plans from McLaren Health Plan Community and Providence Health Plan list Kerby Killingham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kerby Killingham was last updated on January 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.