Active NPI
Jeremy Ryan Bilderback, MA, LLPC
- Counselor
- Traverse City, MI
National Provider Identifier
1659903490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401017749
- Practice address
- 928 S Garfield Ave Ste 3a
Traverse City, MI 49686-2403 - Phone
- (231) 392-4638
- NPI assigned
- Feb 10, 2020
- Sex
- Male
- Sole proprietor
- No
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 | 6401017749 | Primary |
Addresses
Primary practice location
928 S Garfield Ave Ste 3a
Traverse City, MI 49686-2403
Mailing address
4316 5 Mile Rd
Williamsburg, MI 49690-9317
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581292800000",
"number": "1659903490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4316 5 MILE RD",
"city": "WILLIAMSBURG",
"state": "MI",
"postal_code": "496909317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 S GARFIELD AVE STE 3A",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496862403",
"telephone_number": "231-392-4638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BILDERBACK",
"first_name": "JEREMY",
"middle_name": "RYAN",
"credential": "MA, LLPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-10",
"last_updated": "2020-02-10",
"certification_date": "2020-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": "6401017749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
- Biene Star Counseling and Wellness
- Douglas Scott Bieniek
- Courtney Biggar, LLMSW
- Margaret Olsen Biggar, LLBSW
- Marina Bigger
- Biocare Medicine PLLC
- Biocare PLLC 2
- Birch Tree Podiatry Group PC
- Birchwood Nursing Center Inc. (Tendercare Health Center - Birchwood)
- Birchwood Nursing Center Inc. (Tendercare Health Center - Birchwood)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.