Individual provider Active NPI

Jamie Lee Pelishek

  • Mental Health Counselor
  • Holland, MI
National Provider Identifier
1386598290
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6801104487 Issued in MI
Practice address
11656 Barkton Dr
Holland, MI 49424-8337
Phone
(920) 445-5330
NPI assigned
Feb 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6801104487 MI Primary

Addresses

Primary practice location

11656 Barkton Dr
Holland, MI 49424-8337

Mailing address

11656 Barkton Dr
Holland, MI 49424-8337
Phone (920) 445-5330

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
I20260513001410 MI Practitioner - Clinical Social Worker 3072082692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1457 Hazen St SE
Grand Rapids, MI 49507-3712

333 Bridge St NW
Suite 1120
Grand Rapids, MI 49504-5356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801104487MIMDMental Health Counselor

Organizations & group practices 1

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": "1772064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1386598290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11656 BARKTON DR",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248337",
            "telephone_number": "920-445-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11656 BARKTON DR",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248337",
            "telephone_number": "920-445-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELISHEK",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-26",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801104487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.