Ivy Rebecca Kowalski, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401017786 Issued in MI

Practice address

2828 Kraft Ave SE Ste 256
Grand Rapids, MI 49512-2076

Phone

(616) 304-3095

Fax

(616) 483-0005

NPI assigned

Mar 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ivy Rebecca Humphrey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Casey Counseling & Consultation LLC

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1235897026
  NPD Authorized official
• Counseling Center of West Michigan, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1437610730
  NPD
• Virtuwell Therapy, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1871356212
  NPD (past)

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

{
    "created_epoch": "1426377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1619360617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 KRAFT AVE SE STE 256",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122076",
            "telephone_number": "616-304-3095",
            "fax_number": "616-483-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 KRAFT AVE SE STE 256",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122076",
            "telephone_number": "616-304-3095",
            "fax_number": "616-483-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "IVY",
        "middle_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-15",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401017786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IVY",
            "last_name": "HUMPHREY",
            "middle_name": "REBECCA",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Polly Kowalka, LBSW
• Sarah Kowalko, BSW
• Ashton Kowalski, MSOT, OTRL
• Christopher Kowalski, PHARM.D.
• Evan Connor Kowalski, MD
• Kyrstin Kowalski
• Megan Diana Kowalski
• Valerie A Kowalski, RD
• Rachel Kowatch, LMSW
• Kayela Danielle Kowitz

• 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 Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.