MEDICARE: JENNIFER JEANNE ELLIS M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6401013557	MI

General Provider Information

NPI Number	:	1609180819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER JEANNE ELLIS M.A.

Provider Business Mailing Address
First Line	:	7745 JONAGOLD DR SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49508-7602
Country	:	US
Telephone Number	:	800-435-2197
Fax Number	:

Provider Business Practice Location Address
First Line	:	7745 JONAGOLD DR SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49508-7602
Country	:	US
Telephone Number	:	616-970-4636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2010
Last Update Date	:	11/15/2013

Similar Medicare Providers

1558178731 — SADIE BECERRA ORTEGA
Practice Location Address:

731 GRAND AVE LOT 135
PLATTEVILLE, CO
80651-7602

Practice Phone: 720-986-2474
Practice Fax:

1518485853 — JENNIFER ROBERTS
Practice Location Address:

1050 36TH ST SE STE 400
GRAND RAPIDS, MI
49508-5581

Practice Phone: 616-965-8158
Practice Fax:

1255282810 — JWAN ABDULGHAFOUR
Practice Location Address:

626 COLEMAN ST SE
GRAND RAPIDS, MI
49508-7400

Practice Phone: 616-272-0123
Practice Fax:

1134592090 — LEANNE JANSEN MA, LLPC, NCC
Practice Location Address:

1044 68TH ST SE
GRAND RAPIDS, MI
49508-7006

Practice Phone: 616-308-2389
Practice Fax:

1336090059 — ERIN M WHITEFORD LMT
Practice Location Address:

3167 KALAMAZOO AVE SE STE 202
GRAND RAPIDS, MI
49508-1475

Practice Phone: 616-389-5166
Practice Fax:

1609870526 — DR. EDWARD THOMAS STERN M.D.
Practice Location Address:

2120 43RD ST SE , STE 700
GRAND RAPIDS, MI
49508-3717

Practice Phone: 616-455-6700
Practice Fax: 616-455-7487

Directions to “ JENNIFER JEANNE ELLIS M.A.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.