Individual provider Active NPI

Christine Wagenfuehr, LPC

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1326636838
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401223433 Issued in MI
Practice address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone
(616) 455-5000
NPI assigned
Jan 10, 2021
Last updated
Sep 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 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 Counselor 101YM0800X 6401223433 MI
Professional Counselor 101YP2500X 6401223433 MI Primary

Addresses

Primary practice location

300 68TH St SE
Grand Rapids, MI 49548-6927

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Other practice location 1

325 84th St SW Ste 103
Byron Center, MI 49315-9350
Phone (616) 805-3660

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
I20231212000304 MI Practitioner - Mental Health Counselor 1759730195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

360 E Beltline Ave NE
Suite 100
Grand Rapids, MI 49506-1214
Phone (616) 805-3660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401223433MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Virtuwell Therapy, LLC Mental Health CurrentSince Feb 4, 2024 Accepting new patients

Locations

325 84th St SW
Ste 103
Byron Center, MI 49315

330 E Beltline Ave NE
Ste 320
Grand Rapids, MI 49506
Phone (616) 745-8640

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (269) 808-7198

65 S Main St
Ste A
Rockford, MI 49341

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1326636838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 84th St SW Ste 103",
            "address_purpose": "LOCATION",
            "city": "Byron Center",
            "state": "MI",
            "postal_code": "493159350",
            "country_code": "US",
            "telephone_number": "616-805-3660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGENFUEHR",
        "first_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401223433",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401223433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.