Individual provider Active NPI

Katie Farnquist, MA COUNSELING, LPC

  • Professional Counselor
  • Jenison, MI
National Provider Identifier
1952845182
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401014659 Issued in MI
Practice address
1388 Baldwin St.
Suite a
Jenison, MI 49426
Phone
(616) 296-2130
NPI assigned
Dec 7, 2016
Last updated
Jan 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401014659 MI Primary

Addresses

Primary practice location

1388 Baldwin St.
Suite a
Jenison, MI 49426

Mailing address

1388 Baldwin St.
Suite a
Jenison, MI 49426
Phone (616) 296-2130

Other identifiers 1

IdentifierTypeStateIssuer
1952845182OtherMILICENSE

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
I20240321002104 MI Practitioner - Mental Health Counselor 4688011034 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401014659MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kristine Koetje Ma, PC CurrentSince Feb 10, 2024 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 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1952845182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1388 BALDWIN ST.",
            "address_2": "SUITE A",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "49426",
            "telephone_number": "616-296-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1388 BALDWIN ST.",
            "address_2": "SUITE A",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "49426",
            "telephone_number": "616-296-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNQUIST",
        "first_name": "KATIE",
        "name_prefix": "Mrs.",
        "credential": "MA COUNSELING, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1952845182",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

Verify at the official NPI Registry.