Michael John Wiersma, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401016613 Issued in MI

Practice address

7791 Byron Center Ave SW
Byron Center, MI 49315-8412

Phone

(800) 453-7733

NPI assigned

Apr 25, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amplified Life Network, LLCGroup PAC ID 7214350271, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Amplified Life Network, LLC

  • Professional Counselor
  • Byron Center, MI
  • NPI 1558713388
  Medicare reassignment Care Compare group NPD
• MJW Counseling Services

  • Community/Behavioral Health Agency
  • Wyoming, MI
  • NPI 1720688617
  NPD Authorized official

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1265920342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11479 92ND AVE",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494017511",
            "telephone_number": "616-214-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7791 BYRON CENTER AVE SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493158412",
            "telephone_number": "800-453-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERSMA",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401016613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anja Elizabeth Whitehouse
• Kimberly Ann Whitely, OD
• Beth Ann Wiegand
• Clay Wielard, DPT
• Christy J Wierenga, LMSW
• Chloe Williams
• Kara Wilmore, DPT
• Sara Jaime Wilson, PA-C
• Wohlford Counseling LLC
• Rosanna Wai-Wen Wong, D.D.S.

• Professional Counselor in Byron Center, MI
• Providers in Byron Center, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.