NPIMap

Organization Active NPI

Centennial Park Counseling, PLLC

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1689814469
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801063539 Issued in MI
Legal business name
CENTENNIAL PARK COUNSELING, PLLC
Practice address
2828 Kraft Ave SE
Suite 186
Grand Rapids, MI 49512
Phone
(616) 949-9550
Fax
(616) 949-9551
NPI assigned
Mar 6, 2009
Last updated
May 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Brian William BerceNPI 1740308436
Title
President/Owner
Phone
(616) 949-9550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 6801063539 MI Primary

Addresses

Primary practice location

2828 Kraft Ave SE
Suite 186
Grand Rapids, MI 49512

Mailing address

2828 Kraft Ave SE Ste 186
Grand Rapids, MI 49512-2076
Phone (616) 949-9550

Other names 1

  • Centennial Park Counseling, PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220824000337 MI Part B Supplier - Clinic/Group Practice 7517340557 Receives reassigned benefits from 10 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

2828 Kraft Ave SE
Ste 18
Grand Rapids, MI 49512
Phone (616) 949-9550

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1689814469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 KRAFT AVE SE STE 186",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122076",
            "telephone_number": "616-949-9550",
            "fax_number": "616-949-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 KRAFT AVE SE",
            "address_2": "SUITE 186",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49512",
            "telephone_number": "616-949-9550",
            "fax_number": "616-949-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL PARK COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-06",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "BERCE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "616-949-9550"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801063539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centennial Park Counseling, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.