Individual provider Active NPI

Lillian Wiser

  • Professional Counselor
  • Grand Haven, MI
National Provider Identifier
1316770118
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PLC8977 Issued in LA
Practice address
15298 Lost Channel TRL
Grand Haven, MI 49417-9516
Phone
(616) 638-6025
NPI assigned
Aug 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X PLC8977 LA Primary

Addresses

Primary practice location

15298 Lost Channel TRL
Grand Haven, MI 49417-9516

Mailing address

15298 Lost Channel TRL
Grand Haven, MI 49417-9516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

790 Fuller Ave NE
Grand Rapids, MI 49503-1918

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PLC8977LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kent County CMH Authority CurrentSince Mar 24, 2025 Accepting new patients
Kent County CMH Authority CurrentSince Mar 24, 2025 Accepting new patients
Kent County CMH Authority Past Accepting new patients

Locations

790 Fuller Ave NE
Grand Rapids, MI 49503
Phone (616) 336-3765

Organizations & group practices 3

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": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1316770118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15298 LOST CHANNEL TRL",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494179516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15298 LOST CHANNEL TRL",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494179516",
            "telephone_number": "616-638-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISER",
        "first_name": "LILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "PLC8977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.