Individual provider Active NPI

Laura Hockenberry Gardner, MA, LLP, LPC

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1447562293
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401015203 Issued in MI
Practice address
3280 E Beltline CT NE
Grand Rapids, MI 49525-9494
Phone
(616) 446-0813
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401015203 MI Primary

Addresses

Primary practice location

3280 E Beltline CT NE
Grand Rapids, MI 49525-9494

Mailing address

3280 E Beltline CT NE
Grand Rapids, MI 49525-9494

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
I20240228000201 MI Practitioner - Mental Health Counselor 0345481719 Practice locations: Grand Rapids, MI; Southfield, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Laura Hockenberry Gardner Mental Health Current Accepting new patients

Locations

3280 Beltline Ct NE
Grand Rapids, MI 49525
Phone (616) 447-3404

Organizations & group practices 1

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": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1447562293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 E BELTLINE CT NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 E BELTLINE CT NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259494",
            "telephone_number": "616-446-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOCKENBERRY GARDNER",
        "first_name": "LAURA",
        "credential": "MA, LLP, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401015203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.