Individual provider Active NPI

William Edward Robinson, M.DIV, MA

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1124633185
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6451018634 Issued in MI
Practice address
3755 Remembrance Rd NW Ste 3
Grand Rapids, MI 49534-7745
Phone
(616) 379-9191
NPI assigned
Sep 15, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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 6451018634 MI Primary

Addresses

Primary practice location

3755 Remembrance Rd NW Ste 3
Grand Rapids, MI 49534-7745

Mailing address

210 Leyden Ave SW
Grand Rapids, MI 49504-6129
Phone (616) 379-9191

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
I20231206002499 MI Practitioner - Mental Health Counselor 0244687531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Immaculate Heart Counseling PLLCGroup PAC ID 2668810839, 2 clinicians

Practice addresses (Care Compare)

3755 Remembrance Rd NW
Suite 3
Walker, MI 49534-7745
Phone (616) 379-9191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6451018634MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Immaculate Heart Counseling PLLC Professional CurrentSince Mar 22, 2024 Accepting new patients
Second Story Counseling II LLC Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

3424 Chicago Dr
Ste 205
Hudsonville, MI 49426
Phone (616) 426-9034

3755 Remembrance Rd NW
Ste 3
Walker, MI 49534
Phone (616) 259-5177

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1124633185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LEYDEN AVE SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495046129",
            "telephone_number": "616-379-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 REMEMBRANCE RD NW STE 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495347745",
            "telephone_number": "616-379-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "WILLIAM",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "M.DIV, MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-15",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6451018634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.