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 1821414566

Pine Rest Christian Mental Health Services is a Mental Health Counselor in Portage, Michigan. Licensed in Michigan. Registered with an NPI since 2014.

Licensed in
MI
In the registry since
2014
Specialties on file
12
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Practice location Address checks out

1350 W Centre Ave Ste 100
Portage, MI 49024-5361
Phone: (269) 910-7327
Fax: (269) 910-7328
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric Hospital (primary) Taxonomy 283Q00000X · Licence 1080000018 (MI)
Mental Health Counselor Taxonomy 101YM0800X
Professional Counselor Taxonomy 101YP2500X
Behavior Analyst Taxonomy 103K00000X
Psychologist Taxonomy 103T00000X
Social Worker Taxonomy 104100000X
Psychiatry Physician Taxonomy 2084P0800X
Occupational Therapist Taxonomy 225X00000X
Speech-Language Pathologist Taxonomy 235Z00000X
Substance Abuse Rehabilitation Facility Taxonomy 324500000X · Licence SA0390191 (MI)
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1821414566
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Fennema — Managed Care Administrator · (616) 281-6372
NPI enumeratedMarch 5, 2014
Last updated in NPPESJune 18, 2026
Certification dateJune 18, 2026
Mailing address300 68th St Se, Grand Rapids, MI 49548-6927

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