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MATTHEW SCOTT PETTINGA MA, LPC
NPI 1124533757
Counselor in Grand Rapids, MI

Active since December 05, 2017
3292 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525(616) 365-8920(616) 365-8971 Get Directions Write a Review

NPPES record last updated: October 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 24, 2021, Dec 5, 2017 (2 updates tracked since 2017).

About Matthew Scott Pettinga Ma, Lpc NPPES

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

MATTHEW SCOTT PETTINGA MA, LPC (NPI 1124533757) is an individual counselor in Grand Rapids, Michigan, licensed in Michigan (6401015324) and active in the NPI registry since December 2017.

NPPES Registry Identity

NPI1124533757
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameMATTHEW SCOTT PETTINGACredential: MA, LPC
Location Address3292 N EVERGREEN DR NEGrand Rapids, MI 49525-9746
Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000
Phone(616) 365-8920
Fax(616) 365-8971
Sole ProprietorYes
Enumeration DateDecember 5, 2017
Last NPPES UpdateOctober 3, 20252 updates tracked since enumeration
NPPES CertifiedOctober 3, 2025
✔ NPI 1124533757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in MI · 6401015324
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
3292 N EVERGREEN DR NE, Grand Rapids, MI 49525
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and more.Insurance ›

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.

NANCY HAMSTREET LMSW
Social Worker (School)
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
RENEE ORR LMSW
Social Worker
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
STEPHANIE BROWN
Social Worker (Clinical)
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
KENDRA-MARIE MADDISON GARCIA MD, BCBA, LBA
Behavior Analyst
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
KRESTIN RADONOVICH PHD
Psychologist (Clinical)
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
LAUREN VANDRUNEN LMSW
Social Worker (Clinical)
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
SUSAN MCKEEBY BCBA, LBA
Behavior Analyst
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
SEAN CROWELL
Occupational Therapist
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Pettinga's NPI number?

The NPI number for Matthew Pettinga is 1124533757. It was assigned to this individual provider in the NPPES registry on December 5, 2017.

Where is Matthew Pettinga located?

Matthew Pettinga practices at 3292 N Evergreen Dr NE, Grand Rapids, MI 49525. The listed phone number is (616) 365-8920.

What is Matthew Pettinga's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

What insurance does Matthew Pettinga accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company, Priority Health and UnitedHealthcare list Matthew Pettinga as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Matthew Pettinga was last updated on October 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.