Stacey Lynn Vandenberg, MA, LPC, NCC, CAADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401006558 Issued in MI

Practice address

2305 E Paris Ave SE
Grand Rapids, MI 49546-2426

Phone

(231) 343-2781

NPI assigned

Jul 6, 2012

Last updated

Sep 27, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Stacey Vandenberg, LLC

  dba Vandenberg Consulting, LLC

  • Community/Behavioral Health Agency
  • Muskegon, MI
  • NPI 1952771495
  NPD (past) Authorized official

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443312000000",
    "number": "1811252737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 DENVER DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494452196",
            "telephone_number": "231-343-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462426",
            "telephone_number": "231-343-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC, NCC, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2015-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401006558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Christian Vandenberg, D.O
• Michael Vandenberg, DPT
• Michelle Vandenberg, LLMSW; BLS
• Ruth Jean Vandenberg, P.A.-C.
• Samantha Vandenberg, FNP
• William Christian Vandenberg, M.D.
• Kylie Jay Vandenberge
• Stacey Michelle Vandenberge, OTR
• Amy Vandenbos
• Erin Elizabeth Vandenbos, RDH

• 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 Sep 27, 2015; 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.