Active NPI
Erica Koetsier, M.A., TLLP
- Counseling Psychologist
- Grand Rapids, MI
National Provider Identifier
1215366174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6301015560
- Practice address
- 2305 E Paris Ave SE
Suite 203
Grand Rapids, MI 49546-2426 - Phone
- (616) 929-0226
- NPI assigned
- Nov 1, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6301015560 | MI | Primary |
Addresses
Primary practice location
2305 E Paris Ave SE
Suite 203
Grand Rapids, MI 49546-2426
Mailing address
2305 E Paris Ave SE
Suite 203
Grand Rapids, MI 49546-2426
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301015560 | MI | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383264000000",
"number": "1215366174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2305 E PARIS AVE SE",
"address_2": "SUITE 203",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495462426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2305 E PARIS AVE SE",
"address_2": "SUITE 203",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495462426",
"telephone_number": "616-929-0226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOETSIER",
"first_name": "ERICA",
"name_prefix": "Mrs.",
"credential": "M.A., TLLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-01",
"last_updated": "2013-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301015560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Nov 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.