Individual provider Active NPI

Brian Ken Fujii, LPC, MAC, NCC

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1396963252
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401018346 Issued in MI
Practice address
1403 60TH St SE
Grand Rapids, MI 49508-7065
Phone
(616) 805-3360
Fax
(616) 805-3631
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC001422 GA
Professional Counselor 101YP2500X 6401018346 MI Primary

Addresses

Primary practice location

1403 60TH St SE
Grand Rapids, MI 49508-7065

Mailing address

1403 60TH St SE
Grand Rapids, MI 49508-7065
Phone (616) 805-3660

Other identifiers 2

IdentifierTypeStateIssuer
6401018346OtherMILPC LICENSE NUMBER
LPC001422OtherGALPC LICENSE NUMBER

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
I20240130003255 MI Practitioner - Mental Health Counselor 1355794918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Center of West Michigan LLCGroup PAC ID 9234469255, 154 clinicians

Practice addresses (Care Compare)

1403 60TH St SE
Grand Rapids, MI 49508-7065
Phone (616) 805-3660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC001422GAMDProfessional Counselor
6401018346MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC CurrentSince Dec 27, 2023 Accepting new patients
Virtuwell Therapy, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 566-1021

1403 60th St SE
Kentwood, MI 49508
Phone (616) 485-9561

65 S Main St
Ste A
Rockford, MI 49341

Organizations & group practices 2

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1396963252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 60TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087065",
            "telephone_number": "616-805-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 60TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087065",
            "telephone_number": "616-805-3360",
            "fax_number": "616-805-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUJII",
        "first_name": "BRIAN",
        "middle_name": "KEN",
        "name_prefix": "Mr.",
        "credential": "LPC, MAC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC001422",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC LICENSE NUMBER",
            "identifier": "6401018346",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC LICENSE NUMBER",
            "identifier": "LPC001422",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.