Pine Rest Christian Mental Health Services
Organization Active NPI Social Worker · Grand Rapids, MI
NPI 1922019157 · NPPES record last updated Sep 23, 2025
Key facts
- NPI
- 1922019157
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Social Worker 104100000X
- Legal business name
- PINE REST CHRISTIAN MENTAL HEALTH SERVICES
- Practice address
- 300 68TH St SE
Grand Rapids, MI 49548-6927 - Phone
- (616) 455-5000
- NPI assigned
- Aug 11, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Authorized official
- Name
- Diane Fennema
- Title
- Managed Care Administrator
- Phone
- (616) 281-6372
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 41
Practitioners 489
-
David Paul Agee, LMSW
-
Andrae Terell Agnew, LMSW
-
David Lee Alberta, LMSW
-
Anna Elaine Allington, LMSW
-
Rebecca Joy Back, LMSW
-
Jennifer Baker, LMSW
-
Susan Littlejohn Bergman, LMSW
-
Daniel Claude Bethel, LMSW
-
Sandra Renee Binnendyk, LMSW
-
Samantha Binns, LMSW
-
Brian Boggiano, LMSW
-
Gary Bonn, MSW
-
Jerrien D Bonnema, LMSW
-
Carol J Bosch, LMSW
-
Jessica Boss, LMSW
-
Allyson M Breish, LMSW
-
Debra A Broughman, LMSW, CAADC
-
Kaitlyn R Burda, LMSW
-
Rafael Caldas, LMSW
-
Teresa Cieslinski, LMSW
-
Molly Cohn, LMSW
-
Douglas Wood Cushman, L. M. S. W.
-
Alexander Daoud, LMSW
-
Melanie Marie Dennison, LMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040123000787 | MI | Part B Supplier - Clinic/Group Practice | 4981506508 |
Receives reassigned benefits from 261 practitioners Practice locations: Holland, MI; Kalamazoo, MI; Portage, MI; Saint Joseph, MI; Traverse City, MI; Zeeland, MI; Spring Lake, MI; Grandville, MI… |
National Provider Directory
- Tax ID family
- Pine Rest Chicago Area
- Part of
- Pine Rest Chicago Area
Locations
3225 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 364-1500
877 Forest Hill Ave SE
Grand Rapids, MI 49546
Phone (616) 258-7507
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | |||
| Social Worker |
104100000X | Yes |
Addresses
Primary practice location
300 68TH St SE
Grand Rapids, MI 49548-6927
Mailing address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000
Other providers in Grand Rapids, MI
- Pine Rest Christian Mental Health Services
- Pine Rest Christian Mental Health Services
- Pine Rest Christian Mental Health Services
- Pine Rest Christian Mental Health Services
- Pine Rest Christian Mental Health Services
- Pine Rest Christian Mental Health Services
- Pine Rest Christian Mental Heatth Services
- Kelly Pines
- Sadie Marie Pingel
- Laura Pingston
All providers in Grand Rapids, MI · Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.