Melissa Ann Potvin

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401010700 Issued in MI

Practice address

1939 S Division Ave.
Grand Rapids, MI 49507

Phone

(616) 247-3815

Fax

(616) 245-0450

NPI assigned

Aug 14, 2008

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

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

Medicare enrollment (NPD)

Enrolled

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.

• Allegan County Community Mental Health Services

  dba OnPoint

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Allegan, MI
  • NPI 1215989231
  Medicare reassignment NPD
• Counseling Center of West Michigan, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1437610730
  Medicare reassignment NPD
• Allegan County Community Mental Health Services

  • Primary Care Clinic/Center
  • Allegan, MI
  • NPI 1528570322
  NPD
• Jack a Dekkinga MD PC

  dba West Michigan Dermatology

  • Dermatology Physician
  • Grandville, MI
  • NPI 1609896034
  NPD (past)
• Virtuwell Therapy, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1871356212
  NPD (past)

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1871749333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 S DIVISION AVE.",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49507",
            "telephone_number": "616-247-3815",
            "fax_number": "616-245-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 S DIVISION AVE.",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49507",
            "telephone_number": "616-247-3815",
            "fax_number": "616-245-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTVIN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Michael Potter, MA
• Ramsey Sha Potter, MD
• Sarah Caldwell Potter, CRNA
• Shelley Joy Potter
• Carol Potts
• Georgianna Poulos, LMSW
• Mon C Poulose, MD
• Kristin Pounders, LBSW
• Zachary Aaron Pounders, DO
• Adam L Powell, D.O.

• 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 Feb 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.