IndividualActive
Jessica Mangan, MA, LPC, LLP
NPI 1720149685 · Counselor · Grand Rapids, MI
Provider details
- NPI number
- 1720149685
- Entity type
- Individual
- Primary specialty
- CounselorBehavioral Health & Social Service Providers
- Credential
- MA, LPC, LLP
- Sex
- Female
- Sole proprietor
- Yes
- License
- 6361000886 (MI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(94/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
300 68th St Se
Grand Rapids, MI 49548-6927
Phone: (616) 455-5270
Fax: (616) 455-5460
Street-level locationGet directions
Mailing address
12895 Woodgrove Dr
South Lyon, MI 48178-8872
Additional practice locations (1)
- 12895 Woodgrove DrSouth Lyon, MI 48178-8872Phone: (269) 598-8780
Registry dates
- Enumerated
- 2006-12-13
- Last updated
- 2024-09-24
- Certified
- 2024-09-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.