Individual provider Active NPI

Leticia De la Paz

  • Health Service Psychologist
  • Grand Rapids, MI
National Provider Identifier
1154291631
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
Practice address
4041 S Norway St SE
Grand Rapids, MI 49546-6156
Phone
(616) 717-3584
Fax
(616) 717-3584
NPI assigned
Nov 10, 2025
Last updated
Nov 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X Primary

Addresses

Primary practice location

4041 S Norway St SE
Grand Rapids, MI 49546-6156

Mailing address

4041 S Norway St SE
Grand Rapids, MI 49546-6156
Phone (616) 717-3584

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

NPI Registry JSON

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1154291631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 S NORWAY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466156",
            "telephone_number": "616-717-3584",
            "fax_number": "616-717-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 S NORWAY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466156",
            "telephone_number": "616-717-3584",
            "fax_number": "616-717-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA PAZ",
        "first_name": "LETICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 10, 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.

Verify at the official NPI Registry.