Active NPI
Charles D Donaldson, LLP, LPC
- Rehabilitation Psychologist
- Holland, MI
National Provider Identifier
1104035385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Psychologist
- License
- 6301009941
- Practice address
- 603 E 16TH St
Holland, MI 49423-3794 - Phone
- (616) 355-3000
- Fax
- (616) 355-7704
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 13
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401003770 | MI | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 6401003770 | MI | |
| Mental Health Counselor | 101YM0800X | 6401003770 | MI | |
| Professional Counselor | 101YP2500X | 6401003770 | MI | |
| Psychologist | 103T00000X | 6301009941 | MI | |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 6301009941 | MI | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 6301009941 | MI | |
| Clinical Psychologist | 103TC0700X | 6301009941 | MI | |
| Counseling Psychologist | 103TC1900X | 6301009941 | MI | |
| Family Psychologist | 103TF0000X | 6301009941 | MI | |
| Forensic Psychologist | 103TF0200X | 6301009941 | MI | |
| Group Psychotherapy Psychologist | 103TP2701X | 6301009941 | MI | |
| Rehabilitation Psychologist | 103TR0400X | 6301009941 | MI | Primary |
Addresses
Primary practice location
603 E 16TH St
Holland, MI 49423-3794
Mailing address
603 E 16TH St
Holland, MI 49423-3794
Phone (616) 355-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0895544 | Other | MI | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401003770 | MI | MD | Professional Counselor |
| 6301009941 | MI | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1104035385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 E 16TH ST",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494233794",
"telephone_number": "616-355-3000",
"fax_number": "616-355-7704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 E 16TH ST",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494233794",
"telephone_number": "616-355-3000",
"fax_number": "616-355-7704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONALDSON",
"first_name": "CHARLES",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "LLP, LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401003770",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "6401003770",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6401003770",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401003770",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301009941",
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "6301009941",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "MI",
"license": "6301009941",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301009941",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301009941",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "MI",
"license": "6301009941",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "MI",
"license": "6301009941",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "MI",
"license": "6301009941",
"primary": false
},
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "MI",
"license": "6301009941",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0895544",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.