Individual provider Active NPI

Jessica Fleser

  • Psychologist
  • Grand Rapids, MI
National Provider Identifier
1255911681
Registry record updated Aug 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6361007721 Issued in MI
Practice address
360 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1214
Phone
(616) 805-3660
NPI assigned
Apr 9, 2021
Last updated
Aug 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6361007721 MI Primary

Addresses

Primary practice location

360 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1214

Mailing address

1257 Apple Creek Dr SE
Grand Rapids, MI 49546-8268
Phone (616) 822-9390

Other practice location 1

1514 Wealthy St SE Ste 246
Grand Rapids, MI 49506-2755
Phone (616) 227-0585

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6361007721MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hope and Innovation Psychologist Current Accepting new patients
Life Journey PLLC Psychologist PastSince Apr 1, 2021 Accepting new patients
Inprocess Counseling LLC PastSince Aug 15, 2021 Accepting new patients
Counseling Center of West Michigan, LLC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724457600000",
    "number": "1255911681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 APPLE CREEK DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468268",
            "telephone_number": "616-822-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061214",
            "telephone_number": "616-805-3660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 Wealthy St SE Ste 246",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495062755",
            "country_code": "US",
            "telephone_number": "616-227-0585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLESER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-09",
        "last_updated": "2024-08-24",
        "certification_date": "2024-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361007721",
            "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 Aug 24, 2024; 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.