NPIMap

Organization Active NPI

LJ Counseling Services LLC

Doing business as Lake Michigan Counseling Services

  • Clinical Social Worker
  • Rockford, MI
National Provider Identifier
1174134654
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LJ COUNSELING SERVICES LLC
Doing business as
Lake Michigan Counseling Services
Practice address
7700 Forest CT NE
Rockford, MI 49341-8114
Phone
(616) 822-2263
NPI assigned
Aug 10, 2020
Last updated
Sep 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Authorized official

Name
Lindsey Brace, LMSWNPI 1760993091
Title
Founder
Phone
(616) 822-2263

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

7700 Forest CT NE
Rockford, MI 49341-8114

Mailing address

7700 Forest CT NE
Rockford, MI 49341-8114
Phone (616) 822-2263

Other names 1

  • Lake Michigan Counseling Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201014000832 MI Part B Supplier - Clinic/Group Practice 9537589593 Receives reassigned benefits from 7 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

4829 E Beltline Ave NE
Ste 302
Grand Rapids, MI 49525
Phone (616) 226-6522

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1174134654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 FOREST CT NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418114",
            "telephone_number": "616-822-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 FOREST CT NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418114",
            "telephone_number": "616-822-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LJ COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "BRACE",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "616-822-2263",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Michigan Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Michigan Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.