Individual provider Active NPI

Alison Preisel-Austhof, LPC

  • Professional Counselor
  • Grand Rapids, MI
National Provider Identifier
1992210678
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401014273 Issued in MI
Practice address
3300 36TH St SE
Grand Rapids, MI 49512-2810
Phone
(616) 942-2110
NPI assigned
Dec 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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 6401014273 MI Primary

Addresses

Primary practice location

3300 36TH St SE
Grand Rapids, MI 49512-2810

Mailing address

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

Other practice location 1

17325 Van Wagoner Rd
Spring Lake, MI 49456-9702
Phone (616) 847-5145

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
I20240104003115 MI Practitioner - Mental Health Counselor 2769833672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pine Rest Christian Mental Health ServicesGroup PAC ID 4981506508, 354 clinicians

Practice addresses (Care Compare)

17325 Van Wagoner Rd
Pine Rest North Shore Clinic
Spring Lake, MI 49456-4607
Phone (616) 847-5145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401014273MIMDProfessional Counselor

Practice roles

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

Locations

17325 Van Wagoner Rd
Spring Lake, MI 49456
Phone (616) 846-9100

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": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1992210678",
    "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": "3300 36TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122810",
            "telephone_number": "616-942-2110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17325 Van Wagoner Rd",
            "address_purpose": "LOCATION",
            "city": "Spring Lake",
            "state": "MI",
            "postal_code": "494569702",
            "country_code": "US",
            "telephone_number": "616-847-5145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PREISEL-AUSTHOF",
        "first_name": "ALISON",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.