Center for Eating Disorders and Mental Wellnes LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CENTER FOR EATING DISORDERS AND MENTAL WELLNES LLC

Practice address

3230 Broadmoor Ave SE Ste D
Kentwood, MI 49512-8180

Phone

(616) 821-7965

NPI assigned

Jan 15, 2025

Last updated

Jan 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cathy Gallegos

Title

Credentialing Manager

Phone

(517) 483-2461

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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.

• Lisbet Brito, LPC

  • Mental Health Counselor
  • Grandville, MI
  • NPI 1114463593

  Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1033920509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 BROADMOOR AVE SE STE D",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495128180",
            "telephone_number": "616-821-7965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 BROADMOOR AVE SE STE D",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495128180",
            "telephone_number": "616-821-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR EATING DISORDERS AND MENTAL WELLNES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "517-483-2461"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Marisa Castillo
• Shawn Castillo, AUD
• Catherine's Health Center (Catherine's Health Center - Crestwood)
• Catherines Health Center (Catherines Health Center at Townline Elementary)
• Dzana Celjo, RN
• Center for Neuropsychology and Behavioral Health
• Edith Cervantes
• Dajane Capri Mone Chapman
• Iain Gemmell Charnley, M.D.
• Lucan Watt Chatterley, DO

• Professional Counselor in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.