Individual provider Active NPI

Ashley Constantine

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1235645417
Registry record updated Mar 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401016599 Issued in MI
Practice address
3300 36TH St SE
Grand Rapids, MI 49512-2810
Phone
(616) 942-2110
NPI assigned
Dec 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301017303 MI
Professional Counselor 101YP2500X 6401016599 MI Primary

Addresses

Primary practice location

3300 36TH St SE
Grand Rapids, MI 49512-2810

Mailing address

2116 N Manitou Cir
Norton Shores, MI 49441-4210

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401016599MIMDProfessional Counselor
6301017303MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speak Easy Mental Wellness Professional Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ashley.constantine.p1@direct.cherryhealth.nextgenshare.com

Organizations & group practices 1

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": "1514160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584230400000",
    "number": "1235645417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 N MANITOU CIR",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494414210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 36TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122810",
            "telephone_number": "616-942-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANTINE",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-25",
        "last_updated": "2020-03-15",
        "certification_date": "2020-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301017303",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401016599",
            "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 Mar 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.