NPIMap

Organization Active NPI

Hra Psychological Services PC

  • Clinical Psychologist
  • Grand Rapids, MI
National Provider Identifier
1003859984
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
HRA PSYCHOLOGICAL SERVICES PC
Practice address
2851 Charlevoix Dr SE Ste 323
Grand Rapids, MI 49546-7092
Phone
(616) 458-0692
Fax
(616) 458-8129
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tracy Heckman, CPB
Title
Practice Manager
Phone
(616) 458-0692

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

2851 Charlevoix Dr SE Ste 323
Grand Rapids, MI 49546-7092

Mailing address

2851 Charlevoix Dr SE Ste 323
Grand Rapids, MI 49546-7092
Phone (616) 458-0692

Other practice location 1

186 S River Ave
Holland, MI 49423-2848
Phone (616) 458-0692

Other practice location 2

128 N Warren Ave Ste B
Big Rapids, MI 49307-3207
Phone (231) 796-2522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031209000700 MI Part B Supplier - Clinic/Group Practice 8820994031 Receives reassigned benefits from 8 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

128 N Warren Ave
Ste B
Big Rapids, MI 49307
Phone (231) 796-2522

2851 Charlevoix Dr SE
Ste 323
Grand Rapids, MI 49546
Phone (616) 458-0692

3940 Peninsular Dr SE
Ste 230
Grand Rapids, MI 49546
Phone (616) 458-0692

186 S River Ave
Holland, MI 49423
Phone (616) 458-0692

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1003859984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 CHARLEVOIX DR SE STE 323",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467092",
            "telephone_number": "616-458-0692",
            "fax_number": "616-458-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 CHARLEVOIX DR SE STE 323",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467092",
            "telephone_number": "616-458-0692",
            "fax_number": "616-458-8129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "186 S River Ave",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494232848",
            "country_code": "US",
            "telephone_number": "616-458-0692",
            "fax_number": "616-458-8129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "128 N Warren Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Big Rapids",
            "state": "MI",
            "postal_code": "493073207",
            "country_code": "US",
            "telephone_number": "231-796-2522",
            "fax_number": "616-458-8129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HRA PSYCHOLOGICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "HECKMAN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "616-458-0692",
        "authorized_official_credential": "CPB"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.