Active NPI
Charlene Marie Haraburda, MA, LLP, RSW
- Psychologist
- Grand Rapids, MI
National Provider Identifier
1104861483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301010951
- Practice address
- 243 68TH St SE
Grand Rapids, MI 49548-6924 - Phone
- (616) 222-5180
- NPI assigned
- Jun 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301010951 | MI | Primary |
Addresses
Primary practice location
243 68TH St SE
Grand Rapids, MI 49548-6924
Mailing address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P10D112750 | Other | MA | BC/BS |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301010951 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104861483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495486927",
"telephone_number": "616-455-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495486924",
"telephone_number": "616-222-5180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARABURDA",
"first_name": "CHARLENE",
"middle_name": "MARIE",
"credential": "MA, LLP, RSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301010951",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "P10D112750",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.