Jacqueline Kay Gerlofs, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401012456 Issued in MI

Practice address

233 Fulton St E Ste 114B
Grand Rapids, MI 49503-3200

Phone

(616) 208-5032

NPI assigned

Apr 23, 2013

Last updated

Jun 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• JKG Counseling & Recovery LLC

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1932724788
  Medicare reassignment NPD

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1265876080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5488 WILSON AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261529",
            "telephone_number": "616-862-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 FULTON ST E STE 114B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033200",
            "telephone_number": "616-208-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERLOFS",
        "first_name": "JACQUELINE",
        "middle_name": "KAY",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401012456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIORAL HEALTH/SOCIAL SERVICES",
            "identifier": "22",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tesla Gerheiser
• Disha Geriani, MD
• Nicole Gerke
• Staci Gerken, RD
• Rachel Diane Sather Gerleman, PA
• Dorothy Barbara Germain, PHARMD
• Lisa Gernand, LMSW
• Brian J Gerondale, MD
• Bryce N Gerondale
• Evan Gerondale, PA

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.