Brian James Mulder, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401224160 Issued in MI

Practice address

30 Jefferson Ave SE
Grand Rapids, MI 49503-4304

Phone

(616) 303-1313

NPI assigned

Oct 13, 2023

Last updated

Oct 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 18, 2024 through Dec 18, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cappon Consulting LLC

  dba Mend

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1457962078
  NPD

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1497536528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 COLORADO AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072214",
            "telephone_number": "616-610-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034304",
            "telephone_number": "616-303-1313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1511 Colorado Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495072214",
            "country_code": "US",
            "telephone_number": "616-610-0286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULDER",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-13",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401224160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asmaa Mukhtar
• Abbey Nolan Mulder, NP
• Allyson Burgess Mulder, D.M.D
• Alyssa Jean Mulder
• Brian A Mulder, D.D.S.
• Cheryl Mulder, BS
• Courtney Joy Mulder, NP
• Helen Mulder, OT
• Jerry Burgess Mulder Jr., DDS PLC
• John J Mulder IV, PA-C

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.