PINE REST CHRISTIAN MENTAL HEALTH SERVICES – Social Worker, NPI 1922019157

PINE REST CHRISTIAN MENTAL HEALTH SERVICES is a healthcare provider. based in Grand rapids, Michigan. specializing in Social Worker. The NPI Number for PINE REST CHRISTIAN MENTAL HEALTH SERVICES is 1922019157

Main info

Organization
Name
PINE REST CHRISTIAN MENTAL HEALTH SERVICES
NPI
1922019157
Phone
(616) 455-5000
Address
300 68TH ST SE
Authorized Official
DIANE FENNEMA MANAGED CARE ADMINISTRATOR
Enumeration Date
11 August 2006
Last Update Date
23 September 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness85
Years active:19State licenses:0Digital endpointsOther names

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Provider Addresses for PINE REST CHRISTIAN MENTAL HEALTH SERVICES

  • Pine Rest Christian Mental Health Services, 300, 68th Street Southeast, Grand Rapids, Gaines Township, Kent County, Michigan, 49501, United States

    GRAND RAPIDS, MI 495486927

    Phone: (616) 455-5000

    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: 2004-01-23

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
O20040123000787OClinic/Group PracticeMITBD

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

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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 49548)

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Reviews

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Frequently asked questions

What number should I use to identify PINE REST CHRISTIAN MENTAL HEALTH SERVICES for billing?
Administrative and clinical systems typically use NPI 1922019157 for PINE REST CHRISTIAN MENTAL HEALTH SERVICES.
Does the public listing show PINE REST CHRISTIAN MENTAL HEALTH SERVICES as active?
PINE REST CHRISTIAN MENTAL HEALTH SERVICES's NPI record reflects an active status in NPPES.
Which specialty label fits PINE REST CHRISTIAN MENTAL HEALTH SERVICES?
NPPES ties PINE REST CHRISTIAN MENTAL HEALTH SERVICES to Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to PINE REST CHRISTIAN MENTAL HEALTH SERVICES?
The directory associates PINE REST CHRISTIAN MENTAL HEALTH SERVICES with Grand Rapids, Michigan. Check all listed addresses for suites or satellite offices.
Why is information missing for PINE REST CHRISTIAN MENTAL HEALTH SERVICES?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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