Active NPI
Melissa Lynn Vander Kooi, LPC
- Counselor
- Wyoming, MI
National Provider Identifier
1629224001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401007890
- Practice address
- 2663 44TH St SW
Wyoming, MI 49519-4189 - Phone
- (616) 822-5518
- NPI assigned
- Aug 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401007890 | MI | Primary |
Addresses
Primary practice location
2663 44TH St SW
Wyoming, MI 49519-4189
Mailing address
2663 44TH St SW Ste 106
Wyoming, MI 49519-4189
Phone (616) 258-2066
Other practice location 1
7400 Emerald Woods Dr SE
Byron Center, MI 49315-8977
Phone (616) 698-6980
Other names 1
- Melissa Lynn De Groff
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401007890 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renewed Clarity Counseling Services LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Wyoming, MI
- NPI 1669993283
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1629224001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2663 44TH ST SW STE 106",
"city": "WYOMING",
"state": "MI",
"postal_code": "495194189",
"telephone_number": "616-258-2066",
"fax_number": "866-752-2359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2663 44TH ST SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495194189",
"telephone_number": "616-822-5518"
}
],
"practiceLocations": [
{
"address_1": "7400 Emerald Woods Dr SE",
"address_purpose": "LOCATION",
"city": "Byron Center",
"state": "MI",
"postal_code": "493158977",
"country_code": "US",
"telephone_number": "616-698-6980",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANDER KOOI",
"first_name": "MELISSA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-17",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401007890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "DE GROFF",
"middle_name": "LYNN",
"credential": "NONE",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.