Individual provider Active NPI

Amy Lynn Piscopink Taylor, M.A., LPC

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1073934295
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401017231 Issued in MI
Practice address
3225 N Evergreen Dr NE
Grand Rapids, MI 49525-9334
Phone
(616) 364-1500
NPI assigned
Dec 16, 2013
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401014006 MI
Professional Counselor 101YP2500X 6401017231 MI Primary

Addresses

Primary practice location

3225 N Evergreen Dr NE
Grand Rapids, MI 49525-9334

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Other practice location 1

40 Jefferson Ave SE
Grand Rapids, MI 49503-4304
Phone (616) 456-1443

Other practice location 2

8333 Felch St
Zeeland, MI 49464-2608
Phone (616) 847-5145

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
I20240119000974 MI Practitioner - Mental Health Counselor 9032561659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

3225 N Evergreen Dr
Pine Rest Northeast Clinic
Grand Rapids, MI 49525-9334
Phone (616) 364-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401014006MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services Professional CurrentSince Jan 1, 2024 Accepting new patients
Pine Rest Christian Mental Health Services Current Accepting new patients

Locations

3225 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 364-1500

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

8333 Felch St
Zeeland, MI 49464
Phone (616) 741-3790

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": "1387152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1073934295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259334",
            "telephone_number": "616-364-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Jefferson Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034304",
            "country_code": "US",
            "telephone_number": "616-456-1443",
            "fax_number": "616-732-6392",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8333 Felch St",
            "address_purpose": "LOCATION",
            "city": "Zeeland",
            "state": "MI",
            "postal_code": "494642608",
            "country_code": "US",
            "telephone_number": "616-847-5145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PISCOPINK TAYLOR",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "M.A., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-16",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014006",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401017231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.