Healthcare Provider Details

I. General information

NPI: 1306357785
Provider Name (Legal Business Name): KIARA ABUAITA LPC, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8991 ALPINE AVE
SPARTA MI
49345-9347
US

IV. Provider business mailing address

8991 ALPINE AVE
SPARTA MI
49345-9347
US

V. Phone/Fax

Practice location:
  • Phone: 574-253-8406
  • Fax:
Mailing address:
  • Phone: 574-253-8406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701013383
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: