Organization Active NPI

Calm Creek Counseling PLLC

  • Mental Health Counselor
  • Grandville, MI
National Provider Identifier
1245922616
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CALM CREEK COUNSELING PLLC
Practice address
4370 Chicago Dr SW # 113
Grandville, MI 49418-1694
Phone
(616) 746-2493
NPI assigned
May 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Authorized official

Name
Nancy Baldus, LPC, LLPNPI 1619336070
Title
Sole Member
Phone
(616) 536-1991

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

4370 Chicago Dr SW # 113
Grandville, MI 49418-1694

Mailing address

4370 Chicago Dr SW # 113
Grandville, MI 49418-1694
Phone (616) 745-2493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231122000770 MI Part B Supplier - Clinic/Group Practice 0244688760 Receives reassigned benefits from 1 practitioner
Practice locations: Grandville, MI

National Provider Directory

National Provider Directory

Locations

4370 Chicago Dr SW
#113
Grandville, MI 49418
Phone (616) 536-1991

4370 Chicago Dr SW
Ste 113
Grandville, MI 49418

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1245922616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 CHICAGO DR SW # 113",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181694",
            "telephone_number": "616-745-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 CHICAGO DR SW # 113",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181694",
            "telephone_number": "616-746-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALM CREEK COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "BALDUS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "616-536-1991",
        "authorized_official_credential": "LPC, LLP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.