Organization Active NPI

Henderson Counseling Services

  • Professional Counselor
  • Grandville, MI
National Provider Identifier
1275808594
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
HENDERSON COUNSELING SERVICES
Practice address
4642 Happy Hollow St SW
Grandville, MI 49418-9620
Phone
(616) 516-1570
NPI assigned
Mar 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Authorized official

Name
Kristine Henderson, MA, LPCNPI 1265578181
Title
Owner
Phone
(616) 516-1570

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

4642 Happy Hollow St SW
Grandville, MI 49418-9620

Mailing address

PO Box 428
Mount Pleasant, MI 48804-0428
Phone (616) 235-2090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240621003290 MI Part B Supplier - Clinic/Group Practice 1759824410 Receives reassigned benefits from 1 practitioner
Practice locations: Grandville, MI

National Provider Directory

National Provider Directory

Locations

4565 Wilson Ave SW
Ste 1A
Grandville, MI 49418
Phone (616) 215-0919

Practitioners & affiliated clinicians

Practitioners 3

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": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1275808594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488040428",
            "telephone_number": "616-235-2090",
            "fax_number": "616-235-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4642 HAPPY HOLLOW ST SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494189620",
            "telephone_number": "616-516-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-516-1570",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "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 Jan 24, 2024; 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.