Individual provider Active NPI

Cheryl Kallio

  • Mental Health Counselor
  • Spring Lake, MI
National Provider Identifier
1871967018
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401017125 Issued in MI
Practice address
17224 Van Wagoner Rd
Spring Lake, MI 49456-9702
Phone
(616) 296-2130
NPI assigned
Nov 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 6401017125 MI Primary

Addresses

Primary practice location

17224 Van Wagoner Rd
Spring Lake, MI 49456-9702

Mailing address

17224 Van Wagoner Rd
Spring Lake, MI 49456-9702
Phone (616) 296-2130

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240226002718 MI Practitioner - Mental Health Counselor 7911342373 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kristine Koetje Ma, PCGroup PAC ID 3375701873, 21 clinicians

Practice addresses (Care Compare)

17224 Van Wagoner Rd
Spring Lake, MI 49456-9702
Phone (616) 296-2130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401017125MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dunegrass Counseling Mental Health Current Accepting new patients
Kristine Koetje Ma, PC CurrentSince Jan 1, 2024 Accepting new patients
Dunegrass Healing CurrentSince Dec 1, 2025 Accepting new patients

Locations

1388 Baldwin St
Ste A
Jenison, MI 49428
Phone (616) 259-9220

17224 Van Wagoner Rd
Spring Lake, MI 49456
Phone (616) 296-2130

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1448668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1871967018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17224 VAN WAGONER RD",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "616-296-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17224 VAN WAGONER RD",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "616-296-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLIO",
        "first_name": "CHERYL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-28",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401017125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, MI

Sources for this page

Verify at the official NPI Registry.