Individual provider Active NPI

Natalie Reider

  • Mental Health Counselor
  • Grand Rapids, MI
National Provider Identifier
1457810178
Registry record updated Aug 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6451023714 Issued in MI
Practice address
2920 Fuller Ave NE Ste 203
Grand Rapids, MI 49505-3458
Phone
(616) 301-5945
NPI assigned
Mar 13, 2019
Last updated
Aug 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 6451023714 MI Primary

Addresses

Primary practice location

2920 Fuller Ave NE Ste 203
Grand Rapids, MI 49505-3458

Mailing address

2920 Fuller Ave NE Ste 203
Grand Rapids, MI 49505-3458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6451023714MIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1457810178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 FULLER AVE NE STE 203",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 FULLER AVE NE STE 203",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053458",
            "telephone_number": "616-301-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDER",
        "first_name": "NATALIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451023714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.