Individual provider Active NPI

Alicia Katherine Mannes, LLPC

  • Professional Counselor
  • Holland, MI
National Provider Identifier
1578682399
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401009558 Issued in MI
Practice address
854 Washington Ave Ste 330
Holland, MI 49423
Phone
(616) 355-3926
NPI assigned
Mar 29, 2007
Last updated
Nov 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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 6401009558 MI Primary

Addresses

Primary practice location

854 Washington Ave Ste 330
Holland, MI 49423

Mailing address

854 Washington Ave Ste 330
Holland, MI 49423-7141
Phone (616) 355-3926

Other practice location 1

421 S Mitchell St
Cadillac, MI 49601-2571
Phone (231) 775-6581

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
I20240224000555 MI Practitioner - Marriage and Family Therapist 9931535283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

854 S Washington Ave
Suite 330
Holland, MI 49423-7141
Phone (616) 355-3956

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401009558MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital CurrentSince Jan 21, 2024 Accepting new patients
Holland Community Hospital CurrentSince Jan 21, 2024 Accepting new patients
Holland Community Hospital Past Accepting new patients

Locations

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

854 Washington Ave
Bldg A
Holland, MI 49423

854 Washington Ave
Ste 330
Holland, MI 49423
Phone (616) 355-3926

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1578682399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 WASHINGTON AVE STE 330",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237141",
            "telephone_number": "616-355-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 WASHINGTON AVE STE 330",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49423",
            "telephone_number": "616-355-3926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 S Mitchell St",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496012571",
            "country_code": "US",
            "telephone_number": "231-775-6581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNES",
        "first_name": "ALICIA",
        "middle_name": "KATHERINE",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401009558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.