Organization Active NPI

Beth Mellema Counseling LLC

  • Mental Health Counselor
  • Grand Rapids, MI
National Provider Identifier
1396353090
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BETH MELLEMA COUNSELING LLC
Practice address
1550 E Beltline Ave SE Ste 255
Grand Rapids, MI 49506-4362
Phone
(616) 947-4440
NPI assigned
Jul 19, 2020
Last updated
Jan 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Elizabeth Gardner, LMSWNPI 1790095834
Title
Owner
Phone
(616) 240-6668

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 CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1550 E Beltline Ave SE Ste 255
Grand Rapids, MI 49506-4362

Mailing address

2181 Engleside Dr SE
Grand Rapids, MI 49546-6224
Phone (616) 240-6668

National Provider Directory

National Provider Directory

Locations

1550 E Beltline Ave SE
Ste 255
Grand Rapids, MI 49506
Phone (616) 747-0700

Practitioners & affiliated clinicians

Practitioners 2

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": "1595116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1396353090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 ENGLESIDE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466224",
            "telephone_number": "616-240-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 E BELTLINE AVE SE STE 255",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064362",
            "telephone_number": "616-947-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH MELLEMA COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-19",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-240-6668",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.