Organization Active NPI

Melissa Muir Counseling Services PLLC

  • Psychologist
  • Grand Rapids, MI
National Provider Identifier
1477019404
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MELISSA MUIR COUNSELING SERVICES PLLC
Practice address
630 Kenmoor Ave SE Ste 101a
Grand Rapids, MI 49546-8626
Phone
(616) 446-8436
Fax
(616) 920-6536
NPI assigned
Feb 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Authorized official

Name
Melissa MuirNPI 1124474820
Title
Owner
Phone
(616) 446-8436

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

630 Kenmoor Ave SE Ste 101a
Grand Rapids, MI 49546-8626

Mailing address

630 Kenmoor Ave SE Ste 101a
Grand Rapids, MI 49546-8626
Phone (616) 446-8436

Other names 1

  • Forest Hills Therapy, PLLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241129000488 MI Part B Supplier - Clinic/Group Practice 6204361116 Receives reassigned benefits from 5 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1477019404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 KENMOOR AVE SE STE 101A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468626",
            "telephone_number": "616-446-8436",
            "fax_number": "616-920-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 KENMOOR AVE SE STE 101A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468626",
            "telephone_number": "616-446-8436",
            "fax_number": "616-920-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA MUIR COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "MUIR",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-446-8436"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Hills Therapy, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 18, 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.