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

MS. Jessica R Fasburg, LPC

Individual provider Professional Counselor · NPI 1356012249

MS. Jessica R Fasburg, LPC is a Mental Health Counselor in Grand Rapids, Michigan. Qualified in 2012, 14 years ago. Practices with Pine Rest Christian Mental Health Services, a 353-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
14
Licensed in
MI
In the registry since
2021
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

300 68th St SE
Grand Rapids, MI 49548-6927
Phone: (616) 258-7467
Fax: (616) 281-6459
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 6401019406 (MI)

Record details

NPI number1356012249
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorNo
NPI enumeratedSeptember 21, 2021
Last updated in NPPESJanuary 17, 2024
Certification dateJanuary 17, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Pine Rest Christian Mental Health Services — 353 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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