Grand Ledge Counseling Center PC
Organization Active NPI Psychologist · Williamsburg, MI
NPI 1083714760 · NPPES record last updated May 21, 2024
Key facts
- NPI
- 1083714760
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- Legal business name
- GRAND LEDGE COUNSELING CENTER PC
- Practice address
- 6526 Deepwater Point Rd
Williamsburg, MI 49690-9246 - Phone
- (517) 627-8357
- Fax
- (517) 627-8972
- NPI assigned
- Sep 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Arthur W Myers, PHD
- Title
- President
- Phone
- (517) 627-8357
Practitioners 7
-
Arthur W Myers, PHD
-
Cynthia M Myers, LMSW ACSW
-
Robin Renwick Piper, LMSW ACSW
-
Dana J Blake, ACSW
-
Michael Brashears, LLP
-
Nancy Spanninga Perry, LMSW ACSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040603000913 | MI | Part B Supplier - Clinic/Group Practice | 9335121375 |
Receives reassigned benefits from 4 practitioners Practice locations: Williamsburg, MI |
National Provider Directory
Locations
110 E Kingsley St
Ann Arbor, MI 48104
Phone (734) 417-7667
207 W Jefferson St
Grand Ledge, MI 48837
Phone (517) 627-5757
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | MI | Yes | |
| Social Worker |
104100000X | MI |
Addresses
Primary practice location
6526 Deepwater Point Rd
Williamsburg, MI 49690-9246
Mailing address
PO Box 10
Mason, MI 48854-0010
NPI Registry JSON
{
"created_epoch": "1158969600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1716249600000",
"number": "1083714760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10",
"city": "MASON",
"state": "MI",
"postal_code": "488540010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6526 DEEPWATER POINT RD",
"city": "WILLIAMSBURG",
"state": "MI",
"postal_code": "496909246",
"telephone_number": "517-627-8357",
"fax_number": "517-627-8972"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAND LEDGE COUNSELING CENTER PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-23",
"last_updated": "2024-05-21",
"certification_date": "2024-05-21",
"status": "A",
"authorized_official_last_name": "MYERS",
"authorized_official_first_name": "ARTHUR",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "517-627-8357",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "MI",
"license": null,
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "MI",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsburg, MI
- Crystal Lake Clinic P.C.
- Daniel & Max, LLC
- David May DO PLLC
- Holly Donner
- Ez Able, LLC
- Cara C Gruber
- Joel Yale Hechtman
- Emily Rosann Hedley
- Paul T Heinzmann
- Shawn Michael Husband
All providers in Williamsburg, MI · Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.