Emily Fortuna, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401016255 Issued in MI

Practice address

3501 Lake Eastbrook Blvd SE Ste 120
Grand Rapids, MI 49546-5939

Phone

(206) 696-8765

NPI assigned

Sep 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Central Michigan College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Emily Fortuna Therapy

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1780390898
  NPD Authorized official

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1750690368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 NEGAUNEE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495065321",
            "telephone_number": "206-696-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE STE 120",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465939",
            "telephone_number": "206-696-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNA",
        "first_name": "EMILY",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401016255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Fortier
• Emily Fortino
• Katelyn Marie Fortney, NP
• Ashley Huntoon Forton
• Stephanie Nicole Forton, MS, LAT, ATC
• Jennifer Fortuna, OTR/L
• Caleb Fortune
• Emily Margaret Forzley
• Gregory Joseph Forzley, M.D.
• Lu'VA Foss

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.