Active NPI
Jennifer McKinstry, MA
- Professional Counselor
- Grand Rapids, MI
National Provider Identifier
1821668476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401019455
- Practice address
- 781 Kenmoor Ave SE Ste C
Grand Rapids, MI 49546-8624 - Phone
- (616) 558-6613
- NPI assigned
- Jun 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401019455 | MI | Primary |
Addresses
Primary practice location
781 Kenmoor Ave SE Ste C
Grand Rapids, MI 49546-8624
Mailing address
959 Diamond Ave NE
Grand Rapids, MI 49503-1256
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401019455 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624752000000",
"number": "1821668476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "959 DIAMOND AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "781 KENMOOR AVE SE STE C",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495468624",
"telephone_number": "616-558-6613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINSTRY",
"first_name": "JENNIFER",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-27",
"last_updated": "2021-06-27",
"certification_date": "2021-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401019455",
"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 Jun 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.