Organization Active NPI

MRJ Counseling LLC

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1306737796
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MRJ COUNSELING LLC
Practice address
330 E Beltline Ave NE Ste 300
Grand Rapids, MI 49506-1267
Phone
(231) 920-3183
NPI assigned
Jul 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Michele Rae Anne Jackson, LMSW, PMH-CNPI 1598193773
Title
Owner
Phone
(231) 920-3183

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

330 E Beltline Ave NE Ste 300
Grand Rapids, MI 49506-1267

Mailing address

2721 Albert Dr SE
East Grand Rapids, MI 49506-4707
Phone (231) 920-3183

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250830000014 MI Part B Supplier - Clinic/Group Practice 6901307982 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

2100 Plainfield Ave NE
Grand Rapids, MI 49505
Phone (231) 920-3183

Practitioners & affiliated clinicians

Practitioners 1

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": "1752451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1306737796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 ALBERT DR SE",
            "city": "EAST GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064707",
            "telephone_number": "231-920-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E BELTLINE AVE NE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061267",
            "telephone_number": "231-920-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRJ COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-13",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "RAE ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-920-3183",
        "authorized_official_credential": "LMSW, PMH-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.