Individual provider Active NPI

Jessica Hope Stovall

  • Mental Health Counselor
  • Holland, MI
National Provider Identifier
1144055583
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6451023741 Issued in MI
Practice address
217 E 24TH St Ste 201
Holland, MI 49423-4973
Phone
(616) 217-9934
NPI assigned
Sep 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6451023741 MI Primary

Addresses

Primary practice location

217 E 24TH St Ste 201
Holland, MI 49423-4973

Mailing address

217 E 24TH St Ste 201
Holland, MI 49423-4973
Phone (616) 217-9934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6451023741MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Leadlight LLC Mental Health CurrentSince Sep 8, 2024 Accepting new patients

Locations

217 E 24th St
Ste 201
Holland, MI 49423
Phone (616) 209-9204

Organizations & group practices 1

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": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1144055583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 E 24TH ST STE 201",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234973",
            "telephone_number": "616-217-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E 24TH ST STE 201",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234973",
            "telephone_number": "616-217-9934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "JESSICA",
        "middle_name": "HOPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451023741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.