Jason E Baniukaitis, MA, LLP

Individual provider Active NPI Counseling Psychologist · Ada, MI

NPI 1467331306 · NPPES record last updated Sep 2, 2026

Key facts

NPI
1467331306
Entity type
Individual (NPI type 1)
Primary specialty
Counseling Psychologist 103TC1900X
License
6361008388 (MI)
Practice address
7195 Thornapple River Dr SE Ste C
Ada, MI 49301-8411
Phone
(616) 929-0248
NPI assigned
Aug 27, 2025
Sex
Male
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6362010197MIMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Sana Initiative, LLC Past
since Sep 3, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6361008388 MI Yes

Addresses

Primary practice location

7195 Thornapple River Dr SE Ste C
Ada, MI 49301-8411

Mailing address

4165 Rex Valley Dr NE
Rockford, MI 49341-8511
Phone (616) 826-3045

Other providers in Ada, MI

All providers in Ada, MI · Counseling Psychologist in Michigan

Sources for this page

Verify at the official NPI Registry.