NPIMap

Organization Active NPI

Truism Center

  • Mental Health Counselor
  • Grand Rapids, MI
National Provider Identifier
1336706480
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
TRUISM CENTER
Practice address
221 Trowbridge St NE Apt 208
Grand Rapids, MI 49503-1891
Phone
(616) 499-7711
NPI assigned
May 23, 2019
Last updated
May 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Authorized official

Name
Robb Kornoelje, LLPC,MANPI 1609432996
Title
Owner
Phone
(616) 499-7711

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
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

221 Trowbridge St NE Apt 208
Grand Rapids, MI 49503-1891

Mailing address

221 Trowbridge St NE Apt 208
Grand Rapids, MI 49503-1891
Phone (616) 499-7711

Other identifiers 1

IdentifierTypeStateIssuer
6401017330OtherSTATE OF MICHIGAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240912003672 MI Part B Supplier - Clinic/Group Practice 8820538184 Receives reassigned benefits from 10 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558569600000",
    "number": "1336706480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TROWBRIDGE ST NE APT 208",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031891",
            "telephone_number": "616-499-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 TROWBRIDGE ST NE APT 208",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031891",
            "telephone_number": "616-499-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUISM CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A",
        "authorized_official_last_name": "KORNOELJE",
        "authorized_official_first_name": "ROBB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-499-7711",
        "authorized_official_credential": "LLPC,MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "6401017330",
            "state": null
        }
    ],
    "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 May 23, 2019; 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.