Individual provider Active NPI

Renee Joy Rose, LPC

  • Mental Health Counselor
  • Jenison, MI
National Provider Identifier
1710265103
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401013361 Issued in MI
Practice address
2084 Pinewood St
Jenison, MI 49428-9117
Phone
(616) 888-5585
NPI assigned
Aug 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401013361 MI Primary

Addresses

Primary practice location

2084 Pinewood St
Jenison, MI 49428-9117

Mailing address

PO Box 851
Jenison, MI 49429-0851
Phone (616) 888-5585

Other practice location 1

602 Michigan Ave
Holland, MI 49423-4918
Phone (616) 395-2828

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
I20250403000092 MI Practitioner - Mental Health Counselor 4183147838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

602 Michigan Ave
Holland, MI 49423-4918
Phone (616) 394-3350

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401013361MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital Mental Health CurrentSince Mar 6, 2025 Accepting new patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Holland Community Hospital Current Accepting new patients
Holland Community Hospital CurrentSince Mar 6, 2025 Accepting new patients
Renee Rose, LLC Mental Health CurrentSince Feb 26, 2023 Accepting new patients
Holland Community Hospital Past Accepting new patients

Locations

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

14998 Cleveland St
Ste H
Spring Lake, MI 49456

Interoperability endpoints

  • Direct secure messaging: reneerose@tdh.allscriptsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1710265103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 851",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494290851",
            "telephone_number": "616-888-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2084 PINEWOOD ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494289117",
            "telephone_number": "616-888-5585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494234918",
            "country_code": "US",
            "telephone_number": "616-395-2828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "RENEE",
        "middle_name": "JOY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401013361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

Verify at the official NPI Registry.