Active NPI
School Counselor Link, LLC
- Counselor
- Grand Rapids, MI
National Provider Identifier
1245887454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Legal business name
- SCHOOL COUNSELOR LINK, LLC
- Doing business as
- Counselor Link, LLC
- Practice address
- 4467 Cascade Rd SE Ste 4481
Grand Rapids, MI 49546-3776 - Phone
- (616) 745-4637
- NPI assigned
- Aug 22, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shawn A Bultsma, PHD, LPC, NCC
- Title
- Counselor
- Phone
- (616) 745-4637
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
4467 Cascade Rd SE Ste 4481
Grand Rapids, MI 49546-3776
Mailing address
327 Carlton Ave SE
Grand Rapids, MI 49506-1609
Phone (616) 745-4637
Other names 1
- Counselor Link, LLC
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566432000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1566604800000",
"number": "1245887454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "327 CARLTON AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495061609",
"telephone_number": "616-745-4637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4467 CASCADE RD SE STE 4481",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495463776",
"telephone_number": "616-745-4637"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SCHOOL COUNSELOR LINK, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-08-22",
"last_updated": "2019-08-24",
"status": "A",
"authorized_official_last_name": "BULTSMA",
"authorized_official_first_name": "SHAWN",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "COUNSELOR",
"authorized_official_telephone_number": "616-745-4637",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD, LPC, NCC"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Counselor Link, LLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Counselor Link, LLC",
"code": "3",
"type": "Doing Business As"
}
]
}
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 Aug 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.