Individual provider Active NPI

Annalise Hammerlund, LPC

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1295297844
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401015759 Issued in MI
Practice address
2050 Breton Rd SE Ste 104
Grand Rapids, MI 49546-5547
Phone
(616) 259-5136
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401015759 MI Primary

Addresses

Primary practice location

2050 Breton Rd SE Ste 104
Grand Rapids, MI 49546-5547

Mailing address

3232 Woodward Ave SW
Wyoming, MI 49509-3038
Phone (616) 644-1400

Other names 1

  • Annalise De Young Former name

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
I20240321002424 MI Practitioner - Mental Health Counselor 4880031137 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401015759MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Expressive Explorations CurrentSince Jan 1, 2024 Accepting new patients

Locations

2050 Breton Rd SE
Ste 104
Grand Rapids, MI 49546
Phone (616) 202-6521

1845 Rw Berends Dr SW
Wyoming, MI 49519
Phone (616) 259-5136

2663 44th St SW
Ste 106
Wyoming, MI 49519
Phone (616) 258-2066

Organizations & group practices 1

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1295297844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 WOODWARD AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495093038",
            "telephone_number": "616-644-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 BRETON RD SE STE 104",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465547",
            "telephone_number": "616-259-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMERLUND",
        "first_name": "ANNALISE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401015759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNALISE",
            "last_name": "DE YOUNG",
            "credential": "LPC, LLPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.