Organization Active NPI

Enlightened Counseling & Wellness PLLC

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1750088522
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ENLIGHTENED COUNSELING & WELLNESS PLLC
Practice address
7912 S 8TH St
Kalamazoo, MI 49009-8955
Phone
(269) 760-6651
NPI assigned
Feb 13, 2023
Last updated
Nov 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Authorized official

Name
Elaine Bussema, LMSWNPI 1013467083
Title
Owner/Ceo
Phone
(269) 760-6651

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

7912 S 8TH St
Kalamazoo, MI 49009-8955

Mailing address

23730 38TH Ave
Mattawan, MI 49071-8692
Phone (269) 760-6651

Other identifiers 1

IdentifierTypeStateIssuer
1013467083OtherMIPERSONAL NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250110000772 MI Part B Supplier - Clinic/Group Practice 4789111766 Receives reassigned benefits from 1 practitioner
Practice locations: Kalamazoo, MI

National Provider Directory

National Provider Directory

Locations

7912 S 8th St
Kalamazoo, MI 49009
Phone (269) 361-1869

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1750088522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23730 38TH AVE",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490718692",
            "telephone_number": "269-760-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7912 S 8TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098955",
            "telephone_number": "269-760-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENLIGHTENED COUNSELING & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-13",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "BUSSEMA",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "269-760-6651",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1013467083",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.