Individual provider Active NPI

Jacqueline Marie Conger, LPC

  • Professional Counselor
  • Traverse City, MI
National Provider Identifier
1508373978
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401018121 Issued in MI
Practice address
697 Hannah Ave Ste E
Traverse City, MI 49686-3399
Phone
(734) 536-6116
NPI assigned
Jan 6, 2018
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401018121 MI Primary

Addresses

Primary practice location

697 Hannah Ave Ste E
Traverse City, MI 49686-3399

Mailing address

697 Hannah Ave Ste E
Traverse City, MI 49686-3399
Phone (734) 536-6116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240321001417 MI Practitioner - Mental Health Counselor 8123363017 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401018121MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Calm Collective LLC Professional CurrentSince Oct 8, 2025 Accepting new patients
Earlene Blevins, Ma, LPC Professional PastSince Nov 8, 2025 Accepting new patients
North Country Community Mental Health Past Accepting new patients

Locations

697 Hannah Ave
Ste E
Traverse City, MI 49686
Phone (231) 486-0119

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1515196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1508373978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 HANNAH AVE STE E",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863399",
            "telephone_number": "734-536-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "697 HANNAH AVE STE E",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863399",
            "telephone_number": "734-536-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONGER",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-06",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.