Bradley Stalker, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401224881 Issued in MI

Practice address

1348 Baldwin St
Jenison, MI 49428-8937

Phone

(616) 404-4564

NPI assigned

Dec 11, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Wellness Counseling LLCGroup PAC ID 8527551811, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Great Lakes Wellness Counseling LLC

  • Professional Counselor
  • Grandville, MI
  • NPI 1437651916
  Medicare reassignment Care Compare group NPD
• Divine Mind Counseling and Consulting Services

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1013523976
  NPD (past)

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1134715303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288937",
            "telephone_number": "616-404-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288937",
            "telephone_number": "616-404-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALKER",
        "first_name": "BRADLEY",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-11",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401224881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1134715303",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437651916",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Spears, LMSW
• Spectrum Health Primary Care Partners (Corewell Health Medical Group West)
• Spectrum Health Primary Care Partners (Corewell Health Medical Group West)
• Anne Sproat, DNP-C
• St Marys Family Phcy Sunset
• Sydney Stanul, DC
• Nicole Steffen, LMSW
• Benjamin Jon Steketee, D.C.
• Donald Alan Steketee, DC
• Carly Stender

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.