Organization Active NPI

JLS Counseling & Mentoring LLC

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1164574430
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801080952 Issued in MI
Legal business name
JLS COUNSELING & MENTORING LLC
Practice address
2268 Thistledowne Dr NE
Grand Rapids, MI 49505-6325
Phone
(616) 940-9090
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Authorized official

Name
Jane L Stockinger, LMSW ACSW BSN RN
Title
Owner
Phone
(616) 940-9090

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 6801080952 MI Primary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 4704077527 MI

Addresses

Primary practice location

2268 Thistledowne Dr NE
Grand Rapids, MI 49505-6325

Mailing address

4310 Leonard St NW
Suite 103
Walker, MI 49534
Phone (616) 453-6329

Other identifiers 1

IdentifierTypeStateIssuer
8008944510OtherBCBS

Other names 1

  • JLS Counseling & Mentoring LLC Other name

National Provider Directory

National Provider Directory

Locations

2828 Kraft Ave SE
Ste 272
Grand Rapids, MI 49512
Phone (616) 940-9090

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1164574430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 LEONARD ST NW",
            "address_2": "SUITE 103",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "49534",
            "telephone_number": "616-453-6329",
            "fax_number": "616-453-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2268 THISTLEDOWNE DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056325",
            "telephone_number": "616-940-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLS COUNSELING & MENTORING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "STOCKINGER",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-940-9090",
        "authorized_official_credential": "LMSW ACSW BSN RN"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801080952",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704077527",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8008944510",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JLS Counseling & Mentoring LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.