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CARMENCITA PERDOMO LPC
NPI 1477911659
Counselor - Professional in Grand Rapids, MI

Active since February 03, 2016PECOS Enrolled
40 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503(616) 456-1443(616) 732-6392 Get Directions Write a Review

NPPES record last updated: August 12, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 12, 2020, Feb 3, 2016 (2 updates tracked since 2016).

About Carmencita Perdomo Lpc NPPES

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

CARMENCITA PERDOMO LPC (NPI 1477911659) is an individual professional provider in Grand Rapids, Michigan, licensed in Michigan (6401015268) and active in the NPI registry since February 2016. She is enrolled in Medicare PECOS and maintains a secondary practice location in Grand Rapids.

NPPES Registry Identity

NPI1477911659
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameCARMENCITA PERDOMOCredential: LPC
Location Address40 JEFFERSON AVE SEGrand Rapids, MI 49503-4304
Mailing Address40 Jefferson Ave SeGrand Rapids, MI 49503-4304 · (616) 456-1443
Phone(616) 456-1443
Fax(616) 732-6392
Sole ProprietorNo
Enumeration DateFebruary 3, 2016
Last NPPES UpdateAugust 12, 20202 updates tracked since enumeration
NPPES CertifiedAugust 12, 2020
✔ NPI 1477911659 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 · 6401015268
40 JEFFERSON AVE SE, Grand Rapids, MI 49503
Open in Google Maps ↗

Secondary Practice Location 1

Location 1233 Fulton St E Ste 526Grand Rapids, MI 49503-3269 · Phone (616) 805-3660

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carmencita Perdomo Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Carmencita Perdomo reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Counseling Center Of West Michigan, LLC
3.8 mi
Mental Health
360 E BELTLINE AVE NE STE 100
Grand Rapids, MI 49506
  • Reassigned Medicare billing, Michigan enrollment
  • 287 clinicians in this Medicare group
NPI 1437610730 (616) 805-3660
Advanced Counseling And Therapy Services
4.6 mi
Clinical
2020 RAYBROOK ST SE, STE 305
Grand Rapids, MI 49546
  • Reassigned Medicare billing, Michigan enrollment
  • 10 clinicians in this Medicare group
NPI 1659720548 (517) 483-2461

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MRS. MARIAN EVELYN LILLY LPC
Counselor (Mental Health)
40 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 356-6247
RUSSELL WALTON BATES JR. LLC
Counselor
40 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 456-1443
MS. COURTNEY LYN SMITH
Counselor (Professional)
40 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 456-1443
MS. REBECCA SUE BUSMAN TLLP
Psychologist (Counseling)
40 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 855-5931
MISS SARAH JEAN RIEMERSMA LMSW
Social Worker (Clinical)
40 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 732-6391
TAMARA T JACKSON
Counselor (Addiction (Substance Use Disorder))
40 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 456-1443
ANDREW SCHMIDL LLMSW
Social Worker (Clinical)
40 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 456-1443
MRS. JACQUELYN LEE LEE MA, LPC
Counselor (Professional)
40 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Kent County (616) 456-1443

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 Carmencita Perdomo's NPI number?

The NPI number for Carmencita Perdomo is 1477911659. It was assigned to this individual provider in the NPPES registry on February 3, 2016.

Where is Carmencita Perdomo located?

Carmencita Perdomo practices at 40 Jefferson Ave SE, Grand Rapids, MI 49503. The listed phone number is (616) 456-1443.

What is Carmencita Perdomo's specialty?

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

Is Carmencita Perdomo enrolled in Medicare?

Yes. Carmencita Perdomo is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Carmencita Perdomo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carmencita Perdomo reassigns Medicare benefits to 2 organizations: Counseling Center Of West Michigan, LLC (Grand Rapids, MI) and Advanced Counseling And Therapy Services (Grand Rapids, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carmencita Perdomo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carmencita Perdomo accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Carmencita Perdomo 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 Carmencita Perdomo was last updated on August 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.