Individual provider Active NPI

Jessica Danielle Hoffmann, MA LPC

  • Professional Counselor
  • Holland, MI
National Provider Identifier
1184238347
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401223254 Issued in MI
Practice address
926 Washington Ave
Holland, MI 49423-7725
Phone
(616) 820-3780
NPI assigned
Sep 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401223254 MI Primary
Mental Health Counselor 101YM0800X 640122354 MI

Addresses

Primary practice location

926 Washington Ave
Holland, MI 49423-7725

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240103003624 MI Practitioner - Mental Health Counselor 5991156994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pine Rest Christian Mental Health ServicesGroup PAC ID 4981506508, 354 clinicians

Practice addresses (Care Compare)

926 S Washington Ave
210 Pine Rest Holland Clinic
Holland, MI 49423-7725
Phone (616) 820-3780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
640122354MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Specialties, PLC CurrentSince May 1, 2023 Accepting new patients
Psychiatric and Psychological Specialties CurrentSince May 14, 2023 Accepting new patients
Pine Rest Christian Mental Health Services Current Accepting new patients
Pine Rest Christian Mental Health Services Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

926 Washington Ave
Ste 210
Holland, MI 49423
Phone (616) 820-3780

926 Washington Ave
Holland, MI 49423
Phone (616) 393-0166

1030 Miners Rd
Saint Joseph, MI 49085
Phone (269) 408-1688

415 Main St
Ste A
Saint Joseph, MI 49085
Phone (269) 408-1688

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27120/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1184238347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 WASHINGTON AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237725",
            "telephone_number": "616-820-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMANN",
        "first_name": "JESSICA",
        "middle_name": "DANIELLE",
        "name_prefix": "Ms.",
        "credential": "MA LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401223254",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "640122354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.