MJR Wellness Counseling, PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

MJR WELLNESS COUNSELING, PLLC

Practice address

401 Center St
South Haven, MI 49090-1315

Phone

(269) 961-1098

NPI assigned

Aug 21, 2021

Organization subpart

No

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

Authorized official

Name

Maria Jesus Rivera, LPCNPI 1457897399

Title

Licensed Professional Counselor

Phone

(269) 961-1098

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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

• Maria Jesus Rivera, COUNSELOR

  • Professional Counselor
  • Portage, MI
  • NPI 1457897399
  Medicare reassignment Authorized official
• Debra L Vandenboom, MAPCC LPC

  • Mental Health Counselor
  • South Haven, MI
  • NPI 1043935687
  Medicare reassignment NPD

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

{
    "created_epoch": "1629504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629504000000",
    "number": "1548936214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ELKENBURG ST",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490901275",
            "telephone_number": "269-961-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CENTER ST",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490901315",
            "telephone_number": "269-961-1098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Elkenburg St",
            "address_purpose": "LOCATION",
            "city": "South Haven",
            "state": "MI",
            "postal_code": "490901275",
            "country_code": "US",
            "telephone_number": "269-961-1098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MJR WELLNESS COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-21",
        "last_updated": "2021-08-21",
        "certification_date": "2021-08-21",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "JESUS",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "269-961-1098",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandeep Maganlal Mehta, RPH
• Meijer, Inc. (Meijer Pharmacy #271)
• Kathleen M Miles
• Addison Miller
• Brice J Miller, PA-C
• Brett Moor
• Caleb Moriarty
• Conor Mullin, MD
• Muriels Place LLC
• Autumn Nichole Neff

• Adult Mental Health Clinic/Center in South Haven, MI
• Providers in South Haven, MI by specialty
• Adult Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2021; 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.