Individual provider Active NPI

Sarah Elizabeth Nyboer, LPC

  • Professional Counselor
  • Holland, MI
National Provider Identifier
1225804255
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401223112 Issued in MI
Practice address
3124 N Wellness Dr Ste 50
Holland, MI 49424-8121
Phone
(616) 805-3660
NPI assigned
Nov 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401223112 MI Primary

Addresses

Primary practice location

3124 N Wellness Dr Ste 50
Holland, MI 49424-8121

Mailing address

743 S Meadow CT
Holland, MI 49423-7488
Phone (616) 566-8932

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
I20231221001379 MI Practitioner - Mental Health Counselor 7517317241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

3124 N Wellness Dr
Suite 50
Holland, MI 49424-8121
Phone (616) 805-3660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC CurrentSince Jan 1, 2024 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients
Jack a Dekkinga MD PC PastSince Dec 3, 2023 Accepting new patients

Locations

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021

3124 N Wellness Dr
Ste 50
Holland, MI 49424
Phone (616) 263-1678

65 S Main St
Ste A
Rockford, MI 49341

Organizations & group practices 3

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": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1225804255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 S MEADOW CT",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237488",
            "telephone_number": "616-566-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 N WELLNESS DR STE 50",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248121",
            "telephone_number": "616-805-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYBOER",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401223112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.