Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Pine Rest Christian Mental Health Services

Organization Mental Health Counselor · NPI 1568040368

Pine Rest Christian Mental Health Services is a Mental Health Counselor in Grand Rapids, Michigan. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
13
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Practice location Address checks out

300 68th St SE
Grand Rapids, MI 49548-6927
Phone: (616) 281-6372
Fax: (616) 281-6459
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X
Mental Health Counselor Taxonomy 101YM0800X
Professional Counselor Taxonomy 101YP2500X
Psychologist Taxonomy 103T00000X
Clinical Psychologist Taxonomy 103TC0700X
Clinical Social Worker Taxonomy 1041C0700X
Pediatrics Physician Taxonomy 208000000X
Psychiatry Physician Taxonomy 2084P0800X
Addiction Psychiatry Physician Taxonomy 2084P0802X
General Practice Physician Taxonomy 208D00000X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1568040368
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Fennema — Managed Care Administrator · (616) 281-6372
Other names Pine Rest Telehealth Clinic; Pine Rest Telehealth Clinic
NPI enumeratedApril 1, 2021
Last updated in NPPESMarch 11, 2022
Certification dateMarch 11, 2022
Mailing address300 68th St Se, Grand Rapids, MI 49548-6927

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