Organization Active NPI

Elevated Wellness Counseling LLC

  • Clinical Social Worker
  • Muskegon, MI
National Provider Identifier
1417712985
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ELEVATED WELLNESS COUNSELING LLC
Practice address
221 W Webster Ave Ste 515
Muskegon, MI 49440-1294
Phone
(616) 844-8038
NPI assigned
Feb 14, 2024
Last updated
Sep 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Authorized official

Name
Amber K BouwkampNPI 1497278212
Title
Owner/Clinical Therapist
Phone
(616) 844-8038

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

221 W Webster Ave Ste 515
Muskegon, MI 49440-1294

Mailing address

100 Madison St
Coopersville, MI 49404-1227
Phone (616) 844-8038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240907000102 MI Part B Supplier - Clinic/Group Practice 3274073077 Receives reassigned benefits from 1 practitioner
Practice locations: Muskegon, MI

National Provider Directory

National Provider Directory

Locations

221 W Webster Ave
Ste 515
Muskegon, MI 49440
Phone (616) 209-8437

Practitioners & affiliated clinicians

Practitioners 1

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": "1707868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1417712985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON ST",
            "city": "COOPERSVILLE",
            "state": "MI",
            "postal_code": "494041227",
            "telephone_number": "616-844-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W WEBSTER AVE STE 515",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494401294",
            "telephone_number": "616-844-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATED WELLNESS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "BOUWKAMP",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "616-844-8038"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.