Individual provider Active NPI

Diana L Hoover, LPC

  • Professional Counselor
  • Grandville, MI
National Provider Identifier
1972710218
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401009647 Issued in MI
Practice address
4211 Parkway Place Dr SW
Grandville, MI 49418-2695
Phone
(616) 222-3700
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180003215 IL
Professional Counselor 101YP2500X 6401009647 MI Primary

Addresses

Primary practice location

4211 Parkway Place Dr SW
Grandville, MI 49418-2695

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Other practice location 1

1122 Healthcare Dr
Sinnissippi Centers
Mount Carroll, IL 61053-1461
Phone (815) 244-1376 ext. 227

Other identifiers 2

IdentifierTypeStateIssuer
101YP2500XMedicaidMI
1982672762MedicaidMI

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
I20240109002007 MI Practitioner - Mental Health Counselor 8729439286 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180003215ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services Professional CurrentSince Jan 1, 2024 Accepting new patients
Pine Rest Christian Mental Health Services Current Accepting new patients

Locations

4211 Parkway Place Dr SW
Grandville, MI 49418
Phone (616) 222-3700

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 2

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1972710218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 PARKWAY PLACE DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182695",
            "telephone_number": "616-222-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1122 Healthcare Dr",
            "address_2": "Sinnissippi Centers",
            "address_purpose": "LOCATION",
            "city": "Mount Carroll",
            "state": "IL",
            "postal_code": "610531461",
            "country_code": "US",
            "telephone_number": "815-244-1376 x227",
            "fax_number": "815-244-3074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "DIANA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180003215",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401009647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YP2500X",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982672762",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.