Individual provider Active NPI

Steven Jahnke, LPC

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1447734520
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401010077 Issued in MI
Practice address
640 3 Mile Rd NW Ste 101
Grand Rapids, MI 49544-8209
Phone
(616) 785-8900
Fax
(616) 785-8949
NPI assigned
Sep 24, 2018
Last updated
Sep 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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 6401010077 MI Primary

Addresses

Primary practice location

640 3 Mile Rd NW Ste 101
Grand Rapids, MI 49544-8209

Mailing address

640 3 Mile Rd NW Ste 101
Grand Rapids, MI 49544-8209
Phone (616) 785-8900

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
I20231219000691 MI Practitioner - Mental Health Counselor 9830549757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Second Story Counseling II LLCGroup PAC ID 6204292063, 18 clinicians

Practice addresses (Care Compare)

3424 Chicago Dr
Suite 205
Hudsonville, MI 49426-1411
Phone (616) 426-9034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1447734520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 3 MILE RD NW STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495448209",
            "telephone_number": "616-785-8900",
            "fax_number": "616-785-8949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 3 MILE RD NW STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495448209",
            "telephone_number": "616-785-8900",
            "fax_number": "616-785-8949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHNKE",
        "first_name": "STEVEN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.