MARY HOLWERDA – Professional Counselor, NPI 1114597580

MARY HOLWERDA is a healthcare provider. based in Grand haven, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 6401009154 (). The NPI Number for MARY HOLWERDA is 1114597580

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
MARY HOLWERDA
NPI
1114597580
Phone
(616) 607-4476
Address
320 COLUMBUS AVE
Enumeration Date
29 June 2021
Last Update Date
29 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6166074476
Graduation Year
2003 (23 years ago)
PAC ID
5991148231
Group Practice PAC ID
2365623428
Professional Enrollment ID
I20240203000363
Address ID
MI494171289GR320XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness75
Years active:4State licenses:1Digital endpointsOther names

2,023 MENTAL HEALTH COUNSELOR in MI

Provider Addresses for MARY HOLWERDA

  • 320 COLUMBUS AVE

    GRAND HAVEN, MI 494171289

    Phone: (616) 607-4476

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240203000363IMental Health CounselorMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49417)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365623428View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Mental Health CounselorMI
Clinical PsychologistMI
Mental Health CounselorMI

Reviews

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Frequently asked questions

How do payers reference MARY HOLWERDA?
For MARY HOLWERDA, use NPI 1114597580 as the unique 10-digit identifier.
Is MARY HOLWERDA still an active registrant?
MARY HOLWERDA carries an active NPI according to the public dataset.
What area of care is associated with MARY HOLWERDA?
MARY HOLWERDA's record emphasizes Professional Counselor. Clinical services aligned with this taxonomy classification.
Is MARY HOLWERDA located near Grand Haven?
MARY HOLWERDA currently maps to Grand Haven, Michigan in this extract.
When was this NPI issued?
Enumeration for MARY HOLWERDA is noted as June 29, 2021 where the registry provides it.

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