NPIMap

Organization Active NPI

Second Story Counseling II LLC

  • Counselor
  • Hudsonville, MI
National Provider Identifier
1013460716
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
SECOND STORY COUNSELING II LLC
Practice address
3424 Chicago Dr Ste 205
Hudsonville, MI 49426-1411
Phone
(616) 426-9034
NPI assigned
Jul 28, 2016
Last updated
Dec 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Walton, LPCNPI 1730530569
Title
Owner
Phone
(616) 426-9034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

3424 Chicago Dr Ste 205
Hudsonville, MI 49426-1411

Mailing address

7678 Cottonwood Dr Ste C
Jenison, MI 49428-7312
Phone (616) 821-8723

Other practice location 1

1750 Grand Ridge Ct NE Ste 200
Grand Rapids, MI 49525-7043
Phone (616) 426-9034

Other practice location 2

170 College Ave Ste 310
Holland, MI 49423-2982
Phone (616) 426-9034

Other names 1

  • Second Story Counseling Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230520000165 MI Part B Supplier - Clinic/Group Practice 6204292063 Receives reassigned benefits from 34 practitioners
Practice locations: Grand Rapids, MI; Hudsonville, MI; Holland, MI

National Provider Directory

National Provider Directory

Locations

1750 Grand Ridge Ct NE
Ste 200
Grand Rapids, MI 49525
Phone (616) 426-9034

170 College Ave
Ste 310
Holland, MI 49423
Phone (616) 426-9034

3424 Chicago Dr
Ste 205
Hudsonville, MI 49426
Phone (616) 426-9034

1675 Baldwin St
Jenison, MI 49428
Phone (616) 426-9034

7678 Cottonwood Dr
Ste C
Jenison, MI 49428
Phone (231) 660-3949

Practitioners & affiliated clinicians

Practitioners 76

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 76

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1013460716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7678 COTTONWOOD DR STE C",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287312",
            "telephone_number": "616-821-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 CHICAGO DR STE 205",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261411",
            "telephone_number": "616-426-9034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 Grand Ridge Ct NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495257043",
            "country_code": "US",
            "telephone_number": "616-426-9034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 College Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494232982",
            "country_code": "US",
            "telephone_number": "616-426-9034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SECOND STORY COUNSELING II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-28",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-426-9034",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Second Story Counseling",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Second Story Counseling",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hudsonville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.