NPIMap

Organization Active NPI

Jeanna Boase, LLC

Doing business as Cultivate Wellness Counseling

  • Mental Health Counselor
  • Kentwood, MI
National Provider Identifier
1952923500
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
JEANNA BOASE, LLC
Doing business as
Cultivate Wellness Counseling
Practice address
1401 60TH St SE Ste B
Kentwood, MI 49508-7065
Phone
(616) 947-3159
NPI assigned
May 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Authorized official

Name
Jeanna Boase, LLCNPI 1225690704
Title
Clinician
Phone
(616) 947-3159

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1401 60TH St SE Ste B
Kentwood, MI 49508-7065

Mailing address

1401 60TH St SE Ste B
Kentwood, MI 49508-7065

Other practice location 1

2422 Burton St SE
Grand Rapids, MI 49546-4809
Phone (616) 947-3159

Other names 1

  • Cultivate Wellness Counseling Doing business as

National Provider Directory

National Provider Directory

Locations

2422 Burton St SE
Grand Rapids, MI 49546
Phone (616) 947-3159

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1589587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1952923500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 60TH ST SE STE B",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495087065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 60TH ST SE STE B",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495087065",
            "telephone_number": "616-947-3159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2422 Burton St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495464809",
            "country_code": "US",
            "telephone_number": "616-947-3159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JEANNA BOASE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-16",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "BOASE",
        "authorized_official_first_name": "JEANNA",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "616-947-3159",
        "authorized_official_credential": "LLC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cultivate Wellness Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.