NPIMap

Organization Active NPI

616 Counseling Professional Corporation

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1467925222
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
616 COUNSELING PROFESSIONAL CORPORATION
Practice address
550 Cascade West Pkwy SE
Grand Rapids, MI 49546-2137
Phone
(616) 930-4123
Fax
(616) 323-3994
NPI assigned
Jan 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Shawn Gauthier, LMSW, ACSW, CAADCNPI 1912196270
Title
Partner & Clinical Social Worker
Phone
(616) 930-4123

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

550 Cascade West Pkwy SE
Grand Rapids, MI 49546-2137

Mailing address

550 Cascade West Pkwy SE
Grand Rapids, MI 49546-2137
Phone (616) 930-4123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190325000834 MI Part B Supplier - Clinic/Group Practice 6901146208 Receives reassigned benefits from 3 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1467925222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 CASCADE WEST PKWY SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462137",
            "telephone_number": "616-930-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CASCADE WEST PKWY SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462137",
            "telephone_number": "616-930-4123",
            "fax_number": "616-323-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "616 COUNSELING PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-04",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "GAUTHIER",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PARTNER & CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "616-930-4123",
        "authorized_official_credential": "LMSW, ACSW, CAADC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Jun 12, 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.