MICHAEL JOHN WIERSMA (LPC) – Professional Counselor, NPI 1265920342

MICHAEL JOHN WIERSMA (LPC) is a healthcare provider. based in Allendale, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 6401016613 (MI). The NPI Number for MICHAEL JOHN WIERSMA (LPC) is 1265920342

Main info

Male
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL JOHN WIERSMA (LPC)
NPI
1265920342
Phone
(616) 214-0356
Address
11479 92ND AVE
Enumeration Date
25 April 2018
Last Update Date
31 July 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6164994711
Graduation Year
2017 (9 years ago)
PAC ID
4880037415
Group Practice PAC ID
7214350271
Professional Enrollment ID
I20240209003043
Address ID
MI493158412BY7791XSWXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,023 MENTAL HEALTH COUNSELOR in MI

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Provider Addresses for MICHAEL JOHN WIERSMA (LPC)

  • 11479, 92nd Avenue, Allendale, Allendale Charter Township, Ottawa County, Michigan, 49401, United States

    ALLENDALE, MI 494017511

    Phone: (616) 214-0356

    Type: Mailing

  • 7791, Byron Center Avenue Southwest, Byron Center, Byron Township, Kent County, Michigan, 49315, United States

    BYRON CENTER, MI 493158412

    Phone: (800) 453-7733

    Type: Location

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: 2024-02-09

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
I20240209003043IMental 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 49401)

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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: 7214350271View full group profile
NameSpecialtyState
Mental Health CounselorMI
Clinical Social WorkerMI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

How do payers reference MICHAEL JOHN WIERSMA (LPC)?
For MICHAEL JOHN WIERSMA (LPC), use NPI 1265920342 as the unique 10-digit identifier.
Would MICHAEL JOHN WIERSMA (LPC) appear as active to a payer?
You can treat MICHAEL JOHN WIERSMA (LPC) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe MICHAEL JOHN WIERSMA (LPC)'s focus?
For MICHAEL JOHN WIERSMA (LPC), the primary taxonomy reads as Professional Counselor. Clinical services aligned with this taxonomy classification.
Is MICHAEL JOHN WIERSMA (LPC) located near Allendale?
MICHAEL JOHN WIERSMA (LPC) currently maps to Allendale, Michigan in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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