Individual provider Active NPI

John R Rathje, MDIV, MA, NCC, LPC

  • Professional Counselor
  • Ann Arbor, MI
National Provider Identifier
1275820128
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401002902 Issued in MI
Practice address
2350 Washtenaw Ave Ste 6B
Ann Arbor, MI 48104-4532
Phone
(314) 255-4453
NPI assigned
Jun 29, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional Counselor 101YP2500X 6401002902 MI Primary

Addresses

Primary practice location

2350 Washtenaw Ave Ste 6B
Ann Arbor, MI 48104-4532

Mailing address

2350 Washtenaw Ave Ste 6B
Ann Arbor, MI 48104-4532
Phone (314) 255-4453

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260409000907 MI Practitioner - Mental Health Counselor 6709351596 Practice locations: Ann Arbor, MI

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2350 Washtenaw Ave
Suite 6B
Ann Arbor, MI 48104-4525
Phone (314) 255-4453

7373 Nichols Rd
Gaines, MI 48436-9714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401002902MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
John R Rathje Professional CurrentSince Dec 1, 2023 Accepting new patients
Center for Counseling and Pastoral Care Professional PastSince Feb 28, 2011 Accepting new patients

Locations

2350 Washtenaw Ave
Ste 6B
Ann Arbor, MI 48104
Phone (314) 255-4453

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1275820128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 WASHTENAW AVE STE 6B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044532",
            "telephone_number": "314-255-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 WASHTENAW AVE STE 6B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044532",
            "telephone_number": "314-255-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHJE",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MDIV, MA, NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401002902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.