Matt Dehoog

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401015057 Issued in MI

Practice address

826 Parchment Dr SE Ste 100
Grand Rapids, MI 49546-2307

Phone

(616) 366-4226

NPI assigned

Feb 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mantra LLC

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1932924594
  NPD Authorized official

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1033701396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4467 BRAEBURN DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462279",
            "telephone_number": "616-581-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 PARCHMENT DR SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462307",
            "telephone_number": "616-366-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHOOG",
        "first_name": "MATT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401015057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark R Dehaan, MD
• Natasha D Dehaan, NP
• Nicole Dehaan, MSPT, PT
• Peter Dehaan, M.A. LLPC, LLMFT
• Ariana Gabrielle Deherder
• Molly Kay Dehoog, LMSW, LCSW
• Kathleen Urban Dehorn, MD
• Samantha Rose Dehring, LMSW, CAADC
• Gregory J Deines, DO
• Jessica Laurel Dejarnatt, LMSW

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.