Individual provider Active NPI

Jonathan Juris Mikelsons, LPC, SCL

  • Counselor
  • Grand Rapids, MI
National Provider Identifier
1558136556
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401225604 Issued in MI
Practice address
360 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1214
Phone
(269) 808-7198
NPI assigned
Nov 20, 2023
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401225604 MI Primary
Mental Health Counselor 101YM0800X 6401225604 MI
Professional Counselor 101YP2500X 6401225604 MI

Addresses

Primary practice location

360 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1214

Mailing address

333 Bridge St NW Ste 1120
Grand Rapids, MI 49504-5356

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
I20251024000469 MI Practitioner - Mental Health Counselor 8527556158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1457 Haven St SE
Grand Rapids, MI 49507-3712

333 Bridge St NW
Suite 1120
Grand Rapids, MI 49504-5356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401225604MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of West Michigan, LLC Mental Health CurrentSince Oct 15, 2025 Accepting new patients
Virtuwell Therapy, LLC Mental Health CurrentSince Feb 4, 2024 Accepting new patients

Locations

333 Bridge St NW
Ste 1120
Grand Rapids, MI 49504
Phone 61680536601005

360 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 560-1562

65 S Main St
Ste A
Rockford, MI 49341

3800 Lake Michigan Dr NW
Walker, MI 49534
Phone (616) 453-8225

3800 Lake Michigan Dr NW
Ste 103
Walker, MI 49534
Phone (616) 499-7209

Organizations & group practices 2

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": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1558136556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BRIDGE ST NW STE 1120",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061214",
            "telephone_number": "269-808-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKELSONS",
        "first_name": "JONATHAN",
        "middle_name": "JURIS",
        "name_prefix": "Mr.",
        "credential": "LPC, SCL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-20",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401225604",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401225604",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401225604",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.