Active NPI
Melista Dee Genzink, LMSW
- Mental Health Counselor
- Grand Rapids, MI
National Provider Identifier
1639418288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 516 Cherry St SE
Grand Rapids, MI 49503-4702 - Phone
- (616) 456-6135
- Fax
- (616) 771-9779
- NPI assigned
- Feb 1, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Clinical Social Worker | 1041C0700X | 6801091836 | MI | |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
516 Cherry St SE
Grand Rapids, MI 49503-4702
Mailing address
516 Cherry St SE
Grand Rapids, MI 49503-4702
Phone (616) 456-6135
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gerontology Network | Mental Health | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359676800000",
"number": "1639418288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 CHERRY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034702",
"telephone_number": "616-456-6135",
"fax_number": "616-771-9779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 CHERRY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034702",
"telephone_number": "616-456-6135",
"fax_number": "616-771-9779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENZINK",
"first_name": "MELISTA",
"middle_name": "DEE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-01",
"last_updated": "2013-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801091836",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.