Green Branches Counseling Associates PLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

GREEN BRANCHES COUNSELING ASSOCIATES PLC

Practice address

4867 E Beltline Ave NE
Grand Rapids, MI 49525-9787

Phone

(616) 485-9047

NPI assigned

Apr 8, 2022

Organization subpart

No

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

Authorized official

Name

Chad Michael Fessenden, LMSWNPI 1386828192

Title

Sole MBR

Phone

(616) 485-9047

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chad Michael Fessenden, MSW, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1386828192
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1376285536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4867 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259787",
            "telephone_number": "616-485-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4867 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259787",
            "telephone_number": "616-485-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN BRANCHES COUNSELING ASSOCIATES PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "FESSENDEN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "616-485-9047",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.