Individual provider Active NPI

Marin Hann, LPC

  • Professional Counselor
  • Wyoming, MI
National Provider Identifier
1073057360
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401015815 Issued in MI
Practice address
3500 Byron Center Ave SW
Wyoming, MI 49519-3260
Phone
(616) 208-9337
NPI assigned
Dec 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401015815 MI Primary

Addresses

Primary practice location

3500 Byron Center Ave SW
Wyoming, MI 49519-3260

Mailing address

3301 S Creek Dr SE Apt 103
Kentwood, MI 49512-8334
Phone (248) 767-4637

Other practice location 1

2340 Dean Lake Ave NE
Grand Rapids, MI 49505-4446
Phone (616) 678-3622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240223003346 MI Practitioner - Mental Health Counselor 3577908011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2566 22 Mile Rd NW
Kent City, MI 49330-9203

3301 S Creek Dr SE
Apt 103
Kentwood, MI 49512-8334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401015815MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sara Marie Rice CurrentSince Dec 16, 2020 Accepting new patients

Locations

2340 Dean Lake Ave NE
Grand Rapids, MI 49505
Phone (616) 361-6014

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1073057360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 S CREEK DR SE APT 103",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495128334",
            "telephone_number": "248-767-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495193260",
            "telephone_number": "616-208-9337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2340 Dean Lake Ave NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495054446",
            "country_code": "US",
            "telephone_number": "616-678-3622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANN",
        "first_name": "MARIN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-06",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401015815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.