Individual provider Active NPI

Matthew J Vandenelst

  • Mental Health Counselor
  • Ada, MI
National Provider Identifier
1235046863
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4764 Fulton St E Ste 204
Ada, MI 49301-9086
Phone
(616) 200-4433
NPI assigned
Aug 27, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MI Primary

Addresses

Primary practice location

4764 Fulton St E Ste 204
Ada, MI 49301-9086

Mailing address

1943 Georgetown Dr SE BLDG 25
Grand Rapids, MI 49506-5409
Phone (616) 446-9016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1235046863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1943 GEORGETOWN DR SE BLDG 25",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495065409",
            "telephone_number": "616-446-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4764 FULTON ST E STE 204",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493019086",
            "telephone_number": "616-200-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENELST",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.