PINE REST CHRISTIAN MENTAL HEALTH SERVICES
NPI 1780695411
Psychologist in Grand Rapids, MI

Active since August 10, 2006
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: October 18, 2026.

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 1780695411) is a healthcare organization registered as a psychologist in Grand Rapids, Michigan and active in the NPI registry since August 2006. The organization lists Diane Fennema, Managed Care Administrator, as its authorized official.

NPPES Registry Identity

NPI1780695411
Entity TypeOrganization
Primary Taxonomy103T00000X
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
Organization SubpartYes
Authorized OfficialDiane FennemaManaged Care Administrator · (616) 281-6372
Enumeration DateAugust 10, 2006
Last NPPES UpdateNovember 4, 2020
NPPES CertifiedNovember 4, 2020
✔ NPI 1780695411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
300 68TH ST SE, Grand Rapids, MI 49548

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pine Rest Christian Mental Health Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

135

Medicare enrollment records show 135 clinicians reassign Medicare billing to Pine Rest Christian Mental Health Services, which bills Medicare for the services they deliver. Of these, 24 practice at this address and 61 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 2

Clinical Psychologist72
Mental Health Counselor63

Nearest to this location (20)

See all 135
Mental Health Counselor
NPI 1043683147
300 68TH ST SE
Grand Rapids, MI 49548
(616) 559-5896
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1205171790
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1952700403
300 68TH ST SE
Grand Rapids, MI 49548
(616) 281-6363
✔ PECOS✔ Accepts MedicareSame address
Mental Health Counselor
NPI 1336548122
300 68TH ST SE
Grand Rapids, MI 49548
(616) 559-5896
✔ PECOSSame address
Clinical Psychologist
NPI 1598712184
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Mental Health Counselor
NPI 1356012249
300 68TH ST SE
Grand Rapids, MI 49548
(616) 258-7467
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1295084390
300 68TH STREET SE
Grand Rapids, MI 49548
(616) 455-5270
✔ PECOS✔ Accepts MedicareSame address
Mental Health Counselor
NPI 1841888401
300 68TH ST SE
Grand Rapids, MI 49548
(616) 258-7467
✔ PECOS✔ Accepts MedicareSame address
Mental Health Counselor
NPI 1346435286
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOSSame address
Mental Health Counselor
NPI 1477827152
300 68TH ST SE
Grand Rapids, MI 49548
(616) 258-7467
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1700268182
300 68TH ST SE CAMPUS CLINIC
Grand Rapids, MI 49548
(616) 258-7429
✔ PECOSSame address
Clinical Psychologist
NPI 1871813089
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5270
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1568477842
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOSSame address
Mental Health Counselor
NPI 1134442502
300 68TH ST SE
Grand Rapids, MI 49548
(616) 258-7467
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1376084343
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Mental Health Counselor
NPI 1609925502
300 68TH ST SE
Grand Rapids, MI 49548
(616) 559-5896
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1437165404
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOSSame address
Clinical Psychologist
NPI 1417965195
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOSSame address
Mental Health Counselor
NPI 1720242399
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Mental Health Counselor
NPI 1104559095
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5270
✔ PECOS✔ Accepts MedicareSame address
See all 135 clinicians

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

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 Pine Rest Christian Mental Health Services's NPI number?

The NPI number for Pine Rest Christian Mental Health Services is 1780695411. It was assigned to this organization in the NPPES registry on August 10, 2006.

Where is Pine Rest Christian Mental Health Services located?

Pine Rest Christian Mental Health Services is located at 300 68th St SE, Grand Rapids, MI 49548. The listed phone number is (616) 455-5000.

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

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Pine Rest Christian Mental Health Services enrolled in Medicare?

Yes. Pine Rest Christian Mental Health Services is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pine Rest Christian Mental Health Services?

According to the CMS Revalidation Reassignment List (October 2026 release), 135 clinicians in 2 Medicare specialties reassign their Medicare billing to Pine Rest Christian Mental Health Services. A 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 the clinician's services. The largest specialties are Clinical Psychologist (72) and Mental Health Counselor (63). Of these, 24 practice at this address and 61 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Pine Rest Christian Mental Health Services accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Pine Rest Christian Mental Health Services 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 Pine Rest Christian Mental Health Services was last updated on November 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.