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Pine Rest Christian Mental Health Services

Psychiatric Hospital in Traverse City, MI · enumerated 2007 · authorized official Diane Fennema, Managed Care Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1124171954

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Registry record

Entity type Organization (Type 2)
Legal business name Pine Rest Christian Mental Health Services
Parent organization Pine Rest Christian Mental Health Services
Practice address 700 E Hammond Rd Ste 200, Traverse City, MI, 49686
Phone (231) 947-2255
Fax (231) 947-5982
Enumeration date Jan 18, 2007
Last updated in NPPES Jun 18, 2026

Taxonomy & classification

101Y00000X Counselor Behavioral Health & Social Service Providers Secondary
101YP2500X Professional Counselor Behavioral Health & Social Service Providers Secondary
103G00000X Clinical Neuropsychologist Behavioral Health & Social Service Providers Secondary
103K00000X Behavior Analyst Behavioral Health & Social Service Providers Secondary
103T00000X Psychologist Behavioral Health & Social Service Providers Secondary
104100000X Social Worker Behavioral Health & Social Service Providers Secondary
1041S0200X School Social Worker Behavioral Health & Social Service Providers Secondary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Secondary
2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians Secondary
225X00000X Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
235Z00000X Speech-Language Pathologist Speech, Language and Hearing Service Providers Secondary
283Q00000X Psychiatric Hospital Hospitals Primary
363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Diane Fennema
Title Managed Care Administrator
Phone (616) 281-6372

Other identifiers

Identifier Type State Issuer
260D17625 Other MI BCBS PSYCHIATRIST
680D16189 Other MI PSYCHOLOGISTS
P10D11275 Other MI PSYCHOLOGISTS-DOCTORAL LL
110D148370 Other MI INTERNAL MEDICINE
350D148360 Other MI PEDIATRICS
500D11133 Other MI NURSE PRACTIONERS
800D16222 Other MI SOCIAL WORKERS
PSYCHIATIRSTS Other MI MULTISPECIALTY

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Pine Rest Christian Mental Health Services?
The NPI for Pine Rest Christian Mental Health Services is 1124171954, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Pine Rest Christian Mental Health Services?
NPPES lists Diane Fennema (Managed Care Administrator) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-06-18.