Patrick Aaron Sorrelle, ED.S.

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

2653730 Issued in MI

Practice address

14422 Westwind LN
Grand Haven, MI 49417-9382

Phone

(616) 212-5040

NPI assigned

Sep 20, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1033936208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14422 WESTWIND LN",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494179382",
            "telephone_number": "616-212-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14422 WESTWIND LN",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494179382",
            "telephone_number": "616-212-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORRELLE",
        "first_name": "PATRICK",
        "middle_name": "AARON",
        "credential": "ED.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MI",
            "license": "SP0000303",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MI",
            "license": "2653730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• School Psychologist in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• School Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.