Organization Active NPI

Calm Waters Counseling & Wellness

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1396213880
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CALM WATERS COUNSELING & WELLNESS
Practice address
3301 Veterans Dr Ste 106
Traverse City, MI 49684-4592
Phone
(773) 621-0177
NPI assigned
Nov 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Authorized official

Name
Ms. Jacqueline Marie Hein, MA, LMSW, CAADCNPI 1578005153
Title
Owner/Therapist
Phone
(773) 621-0177

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3301 Veterans Dr Ste 106
Traverse City, MI 49684-4592

Mailing address

3192 Valley LN
Traverse City, MI 49684-4562
Phone (773) 621-0177

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221020001428 MI Part B Supplier - Clinic/Group Practice 5294101952 Receives reassigned benefits from 1 practitioner
Practice locations: Traverse City, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1396213880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3192 VALLEY LN",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844562",
            "telephone_number": "773-621-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 VETERANS DR STE 106",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844592",
            "telephone_number": "773-621-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALM WATERS COUNSELING & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-02",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "HEIN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "773-621-0177",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, LMSW, CAADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.