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 Addiction (Substance Use Disorder) Counselor · NPI 1679777049

Pine Rest Christian Mental Health Services is an Addiction (Substance Use Disorder) Counselor in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2007.

Licensed in
MI
In the registry since
2007
Specialties on file
13
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Practice location Address checks out

243 68th St SE
Grand Rapids, MI 49548-6924
Phone: (616) 281-6836
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Medicine (Internal Medicine) Physician (primary) Taxonomy 207RA0401X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X
Mental Health Counselor Taxonomy 101YM0800X
Professional Counselor Taxonomy 101YP2500X
Behavior Analyst Taxonomy 103K00000X
Psychologist Taxonomy 103T00000X
Social Worker Taxonomy 104100000X
Internal Medicine Physician Taxonomy 207R00000X
Occupational Therapist Taxonomy 225X00000X
Speech-Language Pathologist Taxonomy 235Z00000X
Substance Abuse Rehabilitation Facility Taxonomy 324500000X · Licence 410334 (MI)
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1679777049
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationPine Rest Christian Mental Health Services
Authorized official Diane Fennema — Managed Care Administrator · (616) 281-6372
NPI enumeratedJune 12, 2007
Last updated in NPPESJune 18, 2026
Certification dateJune 18, 2026
Mailing address300 68th St Se, Grand Rapids, MI 49548-6927

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