PINE REST CHRISTIAN MENTAL HEALTH SERVICES
NPI 1033129101
Psychiatry & Neurology - Psychiatry in Grand Rapids, MI

Q: What is Pine Rest Christian Mental Health Services's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Active since August 09, 2006CLIA 23D1081173 · Waiver

300 68TH ST SE, GRAND RAPIDS, MI 49548(616) 455-5000 Get Directions Write a Review

NPPES record last updated: November 4, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Pine Rest Christian Mental Health Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE REST CHRISTIAN MENTAL HEALTH SERVICES (NPI 1033129101) is a healthcare organization registered as a psychiatry in Grand Rapids, Michigan and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through March 11, 2028 and lists Diane Fennema, Managed Care Administrator, as its authorized official.

NPPES Registry Identity

NPI1033129101

Entity TypeOrganization

Primary Taxonomy2084P0800X

Legal Business NamePINE REST CHRISTIAN MENTAL HEALTH SERVICES

Location Address300 68TH ST SEGrand Rapids, MI 49548-6927

Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000

Phone(616) 455-5000

Organization SubpartYes

Authorized OfficialDiane FennemaManaged Care Administrator · (616) 281-6372

Enumeration DateAugust 9, 2006

Last NPPES UpdateNovember 4, 2020

NPPES CertifiedNovember 4, 2020

✔ NPI 1033129101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

300 68TH ST SE, Grand Rapids, MI 49548

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Other Identifiers 1

Other700D16083MI · Bc/bs Multispeciality

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1081173

Pine Rest Christian Mental Health Services · Grand Rapids, MI

Active · expires Mar 11, 2028

CLIA Number23D1081173

Laboratory TypeHospital

Certificate Effective DateMarch 12, 2026

Certificate Expiration DateMarch 11, 2028

Laboratory DirectorValerie Cook

Laboratory Phone(616) 281-6363

Laboratory LocationPine Rest Christian Mental Health Services300 68th Street SE, Grand Rapids, MI 49548

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JILLIAN LEIGH MURRAY L.C.S.W

Social Worker (Clinical)