Individual provider Active NPI

Aaron Collin Reider, LPC

  • Mental Health Counselor
  • Grand Rapids, MI
National Provider Identifier
1720618275
Registry record updated Sep 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401222487 Issued in MI
Practice address
2920 Fuller Ave NE Ste 203
Grand Rapids, MI 49505-3458
Phone
(616) 209-9277
Fax
(616) 369-5813
NPI assigned
Jan 23, 2020
Last updated
Sep 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2024

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 6401222487 MI Primary

Addresses

Primary practice location

2920 Fuller Ave NE Ste 203
Grand Rapids, MI 49505-3458

Mailing address

2920 Fuller Ave NE Ste 203
Grand Rapids, MI 49505-3458
Phone (616) 634-0098

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

State licenses

LicenseStateTypeSpecialty
6401222487MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Anxiety Clinic LLC Mental Health CurrentSince May 26, 2024 Accepting new patients

Locations

2920 Fuller Ave NE
Ste 203
Grand Rapids, MI 49505
Phone (616) 209-9277

534 Fountain St NE
Grand Rapids, MI 49503
Phone (616) 456-1178

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727481600000",
    "number": "1720618275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 FULLER AVE NE STE 203",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053458",
            "telephone_number": "616-634-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 FULLER AVE NE STE 203",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053458",
            "telephone_number": "616-209-9277",
            "fax_number": "616-369-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDER",
        "first_name": "AARON",
        "middle_name": "COLLIN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-23",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401222487",
            "primary": true
        }
    ],
    "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 Sep 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.