Organization Active NPI

Prudentia Counseling and Consulting, LLC

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1912601618
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PRUDENTIA COUNSELING AND CONSULTING, LLC
Practice address
2025 E Beltline Ave SE Ste 102
Grand Rapids, MI 49546-7673
Phone
(616) 446-6718
NPI assigned
Mar 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Authorized official

Name
Mr. Noah J Menerey, LMSW-CAADCNPI 1467550517
Title
Executive Director
Phone
(616) 446-6718

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2025 E Beltline Ave SE Ste 102
Grand Rapids, MI 49546-7673

Mailing address

437 Mulford Dr SE
Grand Rapids, MI 49507-3568
Phone (616) 446-6718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230519000876 MI Part B Supplier - Clinic/Group Practice 5799141628 Receives reassigned benefits from 2 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1912601618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 MULFORD DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495073568",
            "telephone_number": "616-446-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 E BELTLINE AVE SE STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467673",
            "telephone_number": "616-446-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENTIA COUNSELING AND CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "MENEREY",
        "authorized_official_first_name": "NOAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "616-446-6718",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW-CAADC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.