IndividualActive
Matthew Pettinga, MA, LPC
NPI 1124533757 · Counselor · Grand Rapids, MI
Provider details
- NPI number
- 1124533757
- Entity type
- Individual
- Primary specialty
- CounselorBehavioral Health & Social Service Providers
- Credential
- MA, LPC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 6401015324 (MI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3292 N Evergreen Dr Ne
Grand Rapids, MI 49525-9746
Phone: (616) 365-8920
Fax: (616) 365-8971
Street-level locationGet directions
Mailing address
300 68th St Se
Grand Rapids, MI 49548-6927
Registry dates
- Enumerated
- 2017-12-05
- Last updated
- 2025-10-03
- Certified
- 2025-10-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.