Organization Active NPI

Growth Mindset Counseling, PLLC

  • Clinical Social Worker
  • Portage, MI
National Provider Identifier
1295431708
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
GROWTH MINDSET COUNSELING, PLLC
Practice address
526 W Centre Ave
Portage, MI 49024-5306
Phone
(269) 303-2299
NPI assigned
Feb 6, 2023
Last updated
Feb 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Authorized official

Name
Jeff Chicoski, LMSW
Title
Owner/Therapist
Phone
(269) 303-2299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

526 W Centre Ave
Portage, MI 49024-5306

Mailing address

3230 Lites End CT
Portage, MI 49024-2381
Phone (269) 873-7617

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240410002687 MI Part B Supplier - Clinic/Group Practice 5890133714 Receives reassigned benefits from 3 practitioners
Practice locations: Portage, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1295431708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 LITES END CT",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490242381",
            "telephone_number": "269-873-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245306",
            "telephone_number": "269-303-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWTH MINDSET COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-06",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "CHICOSKI",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "269-303-2299",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.