Organization Active NPI

Renee Rose, LLC

  • Counselor
  • Jenison, MI
National Provider Identifier
1114587375
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
RENEE ROSE, LLC
Practice address
2084 Pinewood St
Jenison, MI 49428-9117
Phone
(616) 888-5585
NPI assigned
Jun 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Renee Rose, MA, LPC, ATRNPI 1710265103
Title
Owner
Phone
(616) 888-5585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X

Addresses

Primary practice location

2084 Pinewood St
Jenison, MI 49428-9117

Mailing address

PO Box 851
Jenison, MI 49429-0851
Phone (616) 888-5585

National Provider Directory

National Provider Directory

Locations

14998 Cleveland St
Ste H
Spring Lake, MI 49456

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1114587375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 851",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494290851",
            "telephone_number": "616-888-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2084 PINEWOOD ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494289117",
            "telephone_number": "616-888-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEE ROSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-19",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-888-5585",
        "authorized_official_credential": "MA, LPC, ATR"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.