| Psychology Associates Of Grand Rapids Pc | |
|
1000 Parchment Dr Se Grand Rapids MI 49546-3663 | |
| (616) 957-9112 | |
| (616) 957-2409 |
| Full Name | Psychology Associates Of Grand Rapids Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1000 Parchment Dr Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Craig A De Witt (OWNER) |
| Authorized Official Contact | 6169579112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychology Associates Of Grand Rapids Pc 1000 Parchment Dr Se Grand Rapids MI 49546-3663 Ph: (616) 957-9112 | Psychology Associates Of Grand Rapids Pc 1000 Parchment Dr Se Grand Rapids MI 49546-3663 Ph: (616) 957-9112 |
| NPI Number | 1205017738 |
|---|---|
| Provider Enumeration Date | 11/27/2007 |
| Last Update Date | 03/09/2016 |
| Medicare PECOS PAC ID | 6608826557 |
|---|---|
| Medicare Enrollment ID | O20050127000854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205017738 | NPI | - | NPPES |
| Provider Name | Brett A May |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386792869 PECOS PAC ID: 2062462963 Enrollment ID: I20050128000117 |
| Provider Name | Craig A Dewitt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679621213 PECOS PAC ID: 7315997269 Enrollment ID: I20090827000679 |
| Provider Name | Daniel Dewitt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093863540 PECOS PAC ID: 8224088174 Enrollment ID: I20090910000372 |
| Provider Name | Theresa L Bundy-pham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679801179 PECOS PAC ID: 1456481928 Enrollment ID: I20100609000582 |
| Provider Name | Erin Atkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316106883 PECOS PAC ID: 6901937721 Enrollment ID: I20100623000245 |
| Provider Name | Heather J Menerey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487814026 PECOS PAC ID: 3870763931 Enrollment ID: I20110826000611 |
| Provider Name | Ann M Leasher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417222498 PECOS PAC ID: 5294984134 Enrollment ID: I20121009000429 |
| Provider Name | Betsy J Parolini |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215054739 PECOS PAC ID: 2668530726 Enrollment ID: I20130321000212 |
| Provider Name | Peter T Frommeyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740387539 PECOS PAC ID: 7810127115 Enrollment ID: I20140306001680 |
| Provider Name | Debra Dominiak Rinck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760872790 PECOS PAC ID: 3971828294 Enrollment ID: I20150209001552 |
| Provider Name | Erin G Fish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457724320 PECOS PAC ID: 8123328705 Enrollment ID: I20151203002565 |
| Provider Name | Kristin Vandermolen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417401696 PECOS PAC ID: 6608162243 Enrollment ID: I20160908001559 |
| Provider Name | Bryan Bolea |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316390396 PECOS PAC ID: 9638441454 Enrollment ID: I20170814002747 |
| Provider Name | Maria G Gruppen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265860258 PECOS PAC ID: 8325312747 Enrollment ID: I20170925001344 |
| Provider Name | Beverlee A Ludema |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750631560 PECOS PAC ID: 9830328830 Enrollment ID: I20220405001158 |
| Provider Name | Kelly J Culmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841760972 PECOS PAC ID: 9537555727 Enrollment ID: I20220418000382 |
| Provider Name | Colleen Renee Reynolds Ray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295305811 PECOS PAC ID: 2668852211 Enrollment ID: I20220629001887 |
| Provider Name | Joel Bartlett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306277926 PECOS PAC ID: 7810345469 Enrollment ID: I20231121001617 |
| Provider Name | Nance Robson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831362102 PECOS PAC ID: 1456709690 Enrollment ID: I20231128002394 |
| Provider Name | Zachary Sietsema |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598477192 PECOS PAC ID: 9830548619 Enrollment ID: I20231206001729 |
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