Jennifer R Bevington, LMSW, CAADC
Individual provider Active NPI Mental Health Counselor · Grand Haven, MI
NPI 1407906753 · NPPES record last updated May 22, 2014
Key facts
- NPI
- 1407906753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 6801088064 (MI)
- Practice address
- 1111 Fulton St
Grand Haven, MI 49417-1529 - Phone
- (616) 846-8244
- Fax
- (616) 842-0886
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Counseling Center of West Michigan LLC
Practice addresses (Care Compare)
3800 Lake Michigan Dr NW
Walker, MI 49534-4583
Phone (616) 805-3660
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100426000330 | MI | Practitioner - Clinical Social Worker | 2365579273 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801088064 | MI | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Rest Christian Mental Health Services | Current |
Accepting new patients | |
| Pine Rest Christian Mental Health Services | Current |
Accepting new patients | |
| Counseling Center of West Michigan, LLC | Mental Health | Current |
Accepting new patients |
| Virtuwell Therapy, LLC | Mental Health | Past |
Accepting new patients |
Locations
600 S Beacon Blvd
Ste A2
Grand Haven, MI 49417
600 S Beacon Blvd
Grand Haven, MI 49417
Phone (616) 691-6764
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
65 S Main St
Ste A
Rockford, MI 49341
3800 Lake Michigan Dr NW
Walker, MI 49534
Phone (616) 453-8225
3800 Lake Michigan Dr NW
Ste 103
Walker, MI 49534
Phone (616) 499-7209
300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 6801088064 | MI | |
| Mental Health Counselor | 101YM0800X | 6801088064 | MI | Yes |
Addresses
Primary practice location
1111 Fulton St
Grand Haven, MI 49417-1529
Mailing address
1111 Fulton St
Grand Haven, MI 49417-1529
Phone (616) 846-8244
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1712452 | Medicaid | MI |
Other providers in Grand Haven, MI
- Houston Bedford
- David Glenn Beighley
- Sara Bergklint
- Kennedy Bergman
- Janice Beuschel
- Trivonnia Blackman
- David Thomas Blanchard
- Dwayne Glenn Bloemers
- Bloom Skin Nutrition, LLC
- Andrew Michael Bobian
All providers in Grand Haven, MI · Mental Health Counselor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.