Individual provider Active NPI

Jacqueline Annisa Whims, LPC

  • Professional Counselor
  • Mason, MI
National Provider Identifier
1679207823
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401224496 Issued in MI
Practice address
923 S Lansing St
Mason, MI 48854-1917
Phone
(517) 930-3071
Fax
(517) 247-2842
NPI assigned
Jul 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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 6401224496 MI Primary

Addresses

Primary practice location

923 S Lansing St
Mason, MI 48854-1917

Mailing address

923 S Lansing St
Mason, MI 48854-1917
Phone (517) 930-3071

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
I20241028003887 MI Practitioner - Mental Health Counselor 8820521925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monarch Counseling LLCGroup PAC ID 2769763978, 7 clinicians

Practice addresses (Care Compare)

306 S Creyts Rd
Monarch Counseling
Lansing, MI 48917-8289
Phone (517) 930-3071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401224496MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch Counseling LLC CurrentSince Oct 1, 2024 Accepting new patients
DBT Institute of Mi PastSince Jul 1, 2022 Accepting new patients
DBT Institute of Mi PastSince May 12, 2024 Accepting new patients

Locations

306 S Creyts Rd
Lansing, MI 48917
Phone (517) 204-1604

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1679207823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 S LANSING ST",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541917",
            "telephone_number": "517-930-3071",
            "fax_number": "517-247-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 S LANSING ST",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541917",
            "telephone_number": "517-930-3071",
            "fax_number": "517-247-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHIMS",
        "first_name": "JACQUELINE",
        "middle_name": "ANNISA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401224496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, MI

Sources for this page

Verify at the official NPI Registry.