Daniel J De Witt, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301005950 Issued in MI

Practice address

1000 Parchment Dr SE
Grand Rapids, MI 49546-3663

Phone

(616) 957-9112

Fax

(616) 957-2409

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychology Associates of Grand Rapids PCGroup PAC ID 6608826557, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Psychology Associates of Grand Rapids PC

  • Psychologist
  • Grand Rapids, MI
  • NPI 1205017738
  Medicare reassignment Care Compare group NPD
• Psychology Associates of Grand Rapids PC

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1073747648
  NPD

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093863540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PARCHMENT DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463663",
            "telephone_number": "616-957-9112",
            "fax_number": "616-957-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PARCHMENT DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463663",
            "telephone_number": "616-957-9112",
            "fax_number": "616-957-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE WITT",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301005950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Lee De Sibour, MD
• Lara De Stefano, MD
• Brian J De Vos, MSW
• Susan De Waard, M.A., LLP
• Craig A De Witt, PSY.D.
• De Young Chiropractic, P.C.
• Aaron Robert De Young, D.C.
• Gretchen Elise De Young, D.C.
• Andrew Michel De Zwaan, DDS
• Sarah Maria De Zwaan, DDS

• Clinical Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.