MRS. ELIZABETH JOANNE VAN PORTFLIET LPC, NCC
NPI 1255112256
Counselor - Professional in Grand Rapids, MI

Q: What is Elizabeth Van Portfliet's NPI number?

The NPI number for Elizabeth Van Portfliet is 1255112256. It was assigned to this individual provider in the NPPES registry on October 6, 2023.

Q: What is Elizabeth Van Portfliet's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: Is Elizabeth Van Portfliet enrolled in Medicare?

No. Elizabeth Van Portfliet has opted out of Medicare through January 3, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since October 06, 2023Opted out of Medicare · through Jan 3, 2027

30 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503(616) 303-1313 Get Directions Write a Review

NPPES record last updated: October 14, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mrs. Elizabeth Joanne Van Portfliet Lpc, Ncc NPPES

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

MRS. ELIZABETH JOANNE VAN PORTFLIET LPC, NCC (NPI 1255112256) is an individual professional provider in Grand Rapids, Michigan, licensed in Michigan (6401224078) and active in the NPI registry since October 2023. She has opted out of Medicare through January 3, 2027 and maintains a secondary practice location in Comstock Park.

NPPES Registry Identity

NPI1255112256

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMRS. ELIZABETH JOANNE VAN PORTFLIETCredential: LPC, NCC

Location Address30 JEFFERSON AVE SEGrand Rapids, MI 49503-4304

Mailing Address745 Easthill Dr NeComstock Park, MI 49321-9509 · (616) 337-8190

Phone(616) 303-1313

Sole ProprietorYes

Enumeration DateOctober 6, 2023

Last NPPES UpdateOctober 14, 2024

NPPES CertifiedOctober 14, 2024

✔ NPI 1255112256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MI · 6401224078

30 JEFFERSON AVE SE, Grand Rapids, MI 49503

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Secondary Practice Location 1

Location 1745 Easthill Dr NEComstock Park, MI 49321-9509 · Phone (616) 337-8190

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Elizabeth Joanne Van Portfliet Lpc, Ncc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 3, 2025 through January 3, 2027.

Opt-Out Effective DateJanuary 3, 2025

Opt-Out In Effect ThroughJanuary 3, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 7

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

JESSICA LEA CUELLAR

Counselor (Addiction (Substance Use Disorder))