CK Psychological Associates, P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301005808 Issued in MI

Legal business name

CK PSYCHOLOGICAL ASSOCIATES, P.C.

Practice address

246 S River Ave
Suite 105
Holland, MI 49423-3253

Phone

(616) 494-0808

Fax

(616) 494-0011

NPI assigned

Apr 16, 2008

Last updated

Oct 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christine J Gockman, PH.D.NPI 1407969991

Title

Clinical Psychologist

Phone

(616) 494-0808

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christine J Gockman, PH.D.

  • Psychologist
  • Holland, MI
  • NPI 1407969991
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1033383591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 S RIVER AVE",
            "address_2": "SUITE 105",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233253",
            "telephone_number": "616-494-0808",
            "fax_number": "616-494-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 S RIVER AVE",
            "address_2": "SUITE 105",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233253",
            "telephone_number": "616-494-0808",
            "fax_number": "616-494-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CK PSYCHOLOGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "GOCKMAN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "616-494-0808",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301005808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Aaron T Clark, PA-C
• Hannah Clark, NP
• Maggie Sue Clark

• Clinical Psychologist in Holland, MI
• Providers in Holland, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; 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.