Grand Rapids Counseling and Consultation LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

GRAND RAPIDS COUNSELING AND CONSULTATION LLC

Practice address

1239 76TH St SW Ste H4
Byron Center, MI 49315-7921

Phone

(616) 258-6270

NPI assigned

Nov 9, 2022

Last updated

Dec 16, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kelly Ibarra, MA, LPCNPI 1063075562

Title

Owner

Phone

(616) 258-6270

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Tax ID family

Grand Rapids Counseling and Consultation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Grand Rapids Counseling and Consultation

  • Professional Counselor
  • Byron Center, MI
  • NPI 1306554282
  NPD tax ID

Locations

Practitioners 5

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.

• Kelly Lynn Ibarra, LPC

  • Mental Health Counselor
  • Byron Center, MI
  • NPI 1063075562
  Medicare reassignment NPD Authorized official
• David Mack Clark

  • Mental Health Counselor
  • Byron Center, MI
  • NPI 1215390265
  Medicare reassignment NPD
• Fallon Lee, LMSW

  • Clinical Social Worker
  • Caledonia, MI
  • NPI 1669056321
  Medicare reassignment NPD
• Whitney Diane McKinney, LMSW

  • Clinical Social Worker
  • Byron Center, MI
  • NPI 1336947282
  Medicare reassignment NPD
• Amanda Nicole Walma, MA LPC

  • Professional Counselor
  • Byron Center, MI
  • NPI 1043674807
  NPD

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1205544087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 76TH ST SW STE H4",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493157921",
            "telephone_number": "616-258-6270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7624 Clyde Park Ave SW",
            "address_purpose": "LOCATION",
            "city": "Byron Center",
            "state": "MI",
            "postal_code": "493157502",
            "country_code": "US",
            "telephone_number": "616-258-6270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "769 Sun Stone Dr SW",
            "address_purpose": "LOCATION",
            "city": "Byron Center",
            "state": "MI",
            "postal_code": "493158396",
            "country_code": "US",
            "telephone_number": "616-258-6270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23706 Vassar Ave",
            "address_purpose": "LOCATION",
            "city": "Hazel Park",
            "state": "MI",
            "postal_code": "480302712",
            "country_code": "US",
            "telephone_number": "616-258-6270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRAND RAPIDS COUNSELING AND CONSULTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "IBARRA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-258-6270",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Walton Goldsholl, MD
• Rebecca Gomez de Tuinstra, PHD
• Good Samaritans Medical Transport LLC
• Brenda Lee Graham
• Grand Rapids Counseling and Consultation
• Ruth Gray
• Rachel Blair Grigoryan, LMSW
• Naomi Beth Grimm
• Jason Robert Haartman, P.A.
• Joshua C Haeck, NP-C

• Counselor in Byron Center, MI
• Providers in Byron Center, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.