Individual provider Active NPI

Sherry Steenwyk

  • Clinical Psychologist
  • Grand Rapids, MI
National Provider Identifier
1093855025
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014852 Issued in MI
Practice address
2025 E Beltline Ave SE Ste 102
Grand Rapids, MI 49546-7673
Phone
(616) 320-4886
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301014852 MI Primary

Addresses

Primary practice location

2025 E Beltline Ave SE Ste 102
Grand Rapids, MI 49546-7673

Mailing address

2025 E Beltline Ave SE Ste 102
Grand Rapids, MI 49546-7673
Phone (616) 320-4886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140505001078 MI Practitioner - Clinical Psychologist 7911130620 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301014852MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services Single Specialty CurrentSince Mar 28, 2014 Accepting new patients
Dr. Sherry Steenwyk, PH.D., LLC Clinical Current Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Mar 28, 2014 Accepting new patients

Locations

2025 E Beltline Ave SE
Ste 102
Grand Rapids, MI 49546
Phone (616) 446-6718

1870 Leonard St NE
Grand Rapids, MI 49505
Phone (616) 956-1122

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1093855025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 E BELTLINE AVE SE STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467673",
            "telephone_number": "616-320-4886",
            "fax_number": "616-957-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 E BELTLINE AVE SE STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467673",
            "telephone_number": "616-320-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEENWYK",
        "first_name": "SHERRY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.