Robert Lewis Eggleston III, MA, LLPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401018202 Issued in MI

Practice address

741 Kenmoor Ave SE Ste B
Grand Rapids, MI 49546-2304

Phone

(616) 425-2412

NPI assigned

Apr 30, 2020

Last updated

Apr 30, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leadlight LLCGroup PAC ID 4284161233, 7 clinicians

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

• Leadlight LLC

  dba Leadlight Counseling

  • Mental Health Counselor
  • Holland, MI
  • NPI 1578279998
  Medicare reassignment Care Compare group NPD
• Bryan Nixon Counseling, LLC

  dba Mindful Counseling GR

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1780021733
  NPD (past)

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

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1851912844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 COLUMBUS AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171500",
            "telephone_number": "616-635-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 KENMOOR AVE SE STE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462304",
            "telephone_number": "616-425-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGLESTON",
        "first_name": "ROBERT",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MA, LLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-30",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018202",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401018202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Kay Eggers, RPH
• Kelly Elizabeth Eggiman
• Ashley Eggleston
• Brady Eggleston
• Elizabeth Ames Eggleston, MS, RD
• Rosanne Scigliano Eggleston, DDS
• Erika Autumn Egnatoski
• Kyleigh Christine Egnatuk, PA-C
• Nnaemeka Ekekwe Egwuatu
• Ehco LLC (Tandem365)

• Mental Health Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; 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.