Kristine A Koetje, MA LPC LLP

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401002021 Issued in MI

Practice address

17224 Van Wagoner Rd
Spring Lake, MI 49456-9702

Phone

(616) 296-2130

Fax

(162) 962-1486

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristine A Wilder Other name

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, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kristine Koetje Ma, PCGroup PAC ID 3375701873, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Kristine Koetje Ma, PC

  • Psychologist
  • Spring Lake, MI
  • NPI 1316010770
  Medicare reassignment Care Compare group NPD Authorized official
• Kristine Koetje Ma, PC

  • Counselor
  • Spring Lake, MI
  • NPI 1609131192
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1164595526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17224 VAN WAGONER RD STE B",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "616-296-2130",
            "fax_number": "616-296-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17224 VAN WAGONER RD",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "616-296-2130",
            "fax_number": "162-962-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOETJE",
        "first_name": "KRISTINE",
        "middle_name": "A",
        "credential": "MA LPC LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401002021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "WILDER",
            "middle_name": "A",
            "credential": "MA LPC LLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kimberly L Malek, Ma, LPC, LCC
• Kayla Ann King, OTR/L
• John Robert Kleinheksel Jr., M. DIV. L.M.S.W.
• Amy Kristine Klintworth
• Nicole Renee Koch
• Michelle Koetje, PT, DPT
• Kowalski Counseling
• Kylee M Kowalski, DLLP
• Kristine Koetje Ma, PC
• Kristine Koetje Ma, PC

• Counselor in Spring Lake, MI
• Providers in Spring Lake, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.