KRISTINE A KOETJE MA LPC LLP
NPI 1164595526
Counselor in Spring Lake, MI

Q: What is Kristine Koetje's NPI number?

The NPI number for Kristine Koetje is 1164595526. It was assigned to this individual provider in the NPPES registry on November 15, 2006. The provider is also known as Kristine A Wilder Ma Lpc LLP.

Q: What is Kristine Koetje's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kristine Koetje was last updated on June 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since November 15, 2006PECOS EnrolledAccepts Medicare Assignment

17224 VAN WAGONER RD, SPRING LAKE, MI 49456(616) 296-2130(162) 962-1486 Get Directions Write a Review

NPPES record last updated: June 5, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kristine A Koetje Ma Lpc Llp NPPES

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

KRISTINE A KOETJE MA LPC LLP (NPI 1164595526) is an individual counselor in Spring Lake, Michigan, licensed in Michigan (6401002021) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1164595526

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameKRISTINE A KOETJECredential: MA LPC LLP

Location Address17224 VAN WAGONER RDSpring Lake, MI 49456-9702

Mailing Address17224 Van Wagoner Rd Ste BSpring Lake, MI 49456-9702 · (616) 296-2130 · Fax (616) 296-2148

Phone(616) 296-2130

Fax(162) 962-1486

Sole ProprietorNo

Medical School CMSOtherGraduated 1991

Enumeration DateNovember 15, 2006

Last NPPES UpdateJune 5, 2025

NPPES CertifiedJune 5, 2025

✔ NPI 1164595526 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 · 6401002021

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.

17224 VAN WAGONER RD, Spring Lake, MI 49456

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Other Names 1

Other Name (5)Kristine A Wilder Ma Lpc Llp

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, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kristine A Koetje Ma Lpc Llp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729246236

PECOS Enrollment IDI20240321002232

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

RACHEL MCCLENAHAN LMSW

Social Worker (Clinical)