PINE REST CHRISTIAN MENTAL HEALTH SERVICES (NPI# 1619341310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619341310 |
| Entity Type | Organization |
| Organization Name | PINE REST CHRISTIAN MENTAL HEALTH SERVICES |
| Practice Address |
9090 S Rodgers Ct Se Caledonia MI 49316-8052 |
| Mailing Address |
300 68th St Se Grand Rapids MI 49548-6927 |
| Practice Telephone | 6168918770 |
| Mailing Telephone | 6164555460 |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | DIANE FENNEMA (MANAGED CARE ADMINISTRATOR) |
| Authorized Official Telephone | 6162816372 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
MI | Behavioral Health & Social Service Providers | |
| N | 103T00000X | Psychologist | MI | Behavioral Health & Social Service Providers | |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MI | Allopathic & Osteopathic Physicians | |
| N | 283Q00000X | Psychiatric Hospital | Hospitals | ||
| N | 363A00000X | Physician Assistant | MI | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363L00000X | Nurse Practitioner | MI | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 104100000X | Social Worker | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154339521 | Pine Rest Christian Mental Health Services | Psychologist | 550 - 3 Mile Rd Nw, Grand Rapids, MI 49544-1673 | 2006-08-03 |
| 1841791357 | Pine Rest Christian Mental Health Services | Substance Abuse Rehabilitation Facility | 300 68th Street Se, Grand Rapids, MI 49548 | 2018-02-21 |
| 1952818551 | Pine Rest Christian Mental Health Services | Substance Abuse Rehabilitation Facility | 450 Meadow Run Dr, Hastings, MI 49058-9053 | 2018-01-04 |
| 1598138810 | Pine Rest Christian Mental Health Services | Counselor | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2015-11-09 |
| 1386015683 | Pine Rest Christian Mental Health Services | Counselor | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2015-10-13 |
| 1467840553 | Pine Rest Christian Mental Health Services | Nurse Practitioner | 17325 Van Wagoner Rd, Spring Lake, MI 49456-9702 | 2014-12-26 |
| 1821414566 | Pine Rest Christian Mental Health Services | Counselor | 1350 W Centre Ave, Portage, MI 49024-5361 | 2014-03-05 |
| 1467873414 | Pine Rest Christian Mental Health Services | Speech-Language Pathologist | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2013-12-18 |
| 1427216241 | Pine Rest Christian Mental Health Services | Counselor | 4294 Laurel Dr, Lake Odessa, MI 48849-9423 | 2008-05-29 |
| 1487837506 | Pine Rest Christian Mental Health Services | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2007-12-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PINE REST CHRISTIAN MENTAL HEALTH SERVICES | 300 68th St Se, Grand Rapids, MI 49548-6927 |
| Iowa Business Entities | PINE REST CHRISTIAN MENTAL HEALTH SERVICES | 300 68th St Se, Grand Rapids, MI 49548 |
| Street Address |
9090 S RODGERS CT SE |
| City | CALEDONIA |
| State | MI |
| Zip Code | 49316-8052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700866308 | Richard Clyde Robertson | Dentist | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2006-01-19 |
| 1326495326 | Pennock Hospital | Nurse Practitioner | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2016-05-19 |
| 1609235621 | Jessica Boss | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2016-02-18 |
| 1457766628 | Racheal Brooker | Nurse Practitioner | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2014-06-26 |
| 1235473794 | Kristen M Ranson | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2012-11-21 |
| 1255612248 | Grace Louise Fryling | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2011-09-02 |
| 1841595006 | Cecily L Sherlock Huizing | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2011-01-20 |
| 1437302551 | Richard C. Robertson Dds Plc | Dentist | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2008-11-03 |
| 1366629883 | Kristin Ranae Kuiper | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2008-01-28 |
| 1992984058 | Michael Jack Reiffer | Social Worker | 9090 S Rodgers Ct Se, Suite D, Caledonia, MI 49316-8052 | 2007-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407326036 | Daina Elizabeth Graves | Occupational Therapist | 10560 Whispering Waters Ln Se, Caledonia, MI 49316 | 2018-11-27 |
| 1033619135 | Spectrum Health Primary Care Partners | Physical Therapist | 6201 68th St Se, Caledonia, MI 49316 | 2018-02-15 |
| 1538672035 | Justin Michael Keely | Student in an Organized Health Care Education/Training Program | 8441 Sunnyview Rd., Caledonia, MI 49316 | 2017-11-07 |
| 1457614521 | Rahaf Halimeh | Dentist | 3625 Riverbed Lane Se, #3, Caledonia, MI 49316 | 2012-06-22 |
| 1487913158 | Adam Zachary Mitchell | Family Medicine | 9090 S Rodgers Ct Se Ste A, Caledonia, MI 49316 | 2012-05-15 |
| 1841588522 | Oday Ali Kasim | Pharmacist | 9375 Cherry Valley Ave., Caledonia, MI 49316 | 2011-07-15 |
| 1417183344 | Allison Leigh Ford | Physical Therapist | 10047 Cross Road Ct. Se, Suite 150, Caledonia, MI 49316 | 2009-06-05 |
| 1336351741 | Paula Delorm | Physical Therapist | 6595 Gracepoint Dr. Se, Caledonia, MI 49316 | 2007-05-06 |
| 1366532798 | Wayne D Westbrook | Dentist | 3125 68th St Se, Dutton, MI 49316 | 2006-10-14 |
| 1629184056 | Patricia Brunck Cassell | Social Worker | 9090 Sourth Rodgers Court Se, Caledonia, MI 49316 | 2006-08-21 |
| Find all providers in zip 49316 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629184056 | Patricia Brunck Cassell | Social Worker | 9090 Sourth Rodgers Court Se, Caledonia, MI 49316 | 2006-08-21 |
| 1609235621 | Jessica Boss | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2016-02-18 |
| 1235473794 | Kristen M Ranson | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2012-11-21 |
| 1407155534 | Lauralee Rea | Social Worker | 9809 Cherry Valley Ave Se, Caledonia, MI 49316-9592 | 2011-03-15 |
| 1841595006 | Cecily L Sherlock Huizing | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2011-01-20 |
| 1366629883 | Kristin Ranae Kuiper | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2008-01-28 |
| 1164575619 | Sharon Cain Maysick | Social Worker | 3350 Brown Rd, Caledonia, NY 14423-9534 | 2007-01-19 |
| 1497855928 | John F Nielsen | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2006-09-24 |
| 1154429942 | Andrea Lynne Reiffer | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447453 | Jenni Kirt | Social Worker | 407 I-75 Bus N, Gaylord, MI 49735 | 2020-11-05 |
| 1679173595 | Laura Ann Dillivan | Social Worker | 1545 Cole Ave Ne, Grand Rapids, MI 49505-5026 | 2020-10-29 |
| 1578163580 | Chaundra Randle | Social Worker | 21951 Boulder Dr, Farmington Hills, MI 48335-3702 | 2020-10-28 |
| 1063012367 | Jenna Brianne Labrecque | Social Worker | 2013 East Castle Dr, Suite B, Kentwood, MI 49508 | 2020-10-27 |
| 1083213227 | Angela Hastings | Social Worker | 2751 Stonebluff Dr Sw, Wyoming, MI 49519-6101 | 2020-10-20 |
| 1952900235 | Garrett Robert Gresly | Social Worker | 181 North Ave Lower Level, Battle Creek, MI 49017-3467 | 2020-10-19 |
| 1376141903 | Debra Ann Alexander-maxie | Social Worker | 3500 S Cedar St Ste 116, Lansing, MI 48910-4684 | 2020-10-15 |
| 1699373308 | Courtney Miller | Social Worker | 41845 Old Bridge Rd, Canton, MI 48188-1242 | 2020-10-14 |
| 1427656123 | Elder Care Services | Social Worker | 21650 W 11 Mile Rd Ste 206, Southfield, MI 48076-3777 | 2020-10-14 |
| 1740888940 | Kathy Jo Coffey | Social Worker | Turning Leaf Behavioral Health Services, 621 E Jolly Rd, Lansing, MI 48909 | 2020-10-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.