NPIMap

Organization Active NPI

Regional Psychology and Wellness, LLC

  • Counseling Psychologist
  • Fremont, MI
National Provider Identifier
1154894376
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
REGIONAL PSYCHOLOGY AND WELLNESS, LLC
Practice address
4845 Snyder Ave
Fremont, MI 49412-8573
Phone
(231) 924-6920
NPI assigned
Jan 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Authorized official

Name
Shanoa Dione Praay, LLPNPI 1306399746
Title
Psychologist
Phone
(616) 994-3389

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

4845 Snyder Ave
Fremont, MI 49412-8573

Mailing address

4845 Snyder Ave
Fremont, MI 49412-8573
Phone (231) 924-6920

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1154894376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 SNYDER AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494128573",
            "telephone_number": "231-924-6920",
            "fax_number": "231-924-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 SNYDER AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494128573",
            "telephone_number": "231-924-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL PSYCHOLOGY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "PRAAY",
        "authorized_official_first_name": "SHANOA",
        "authorized_official_middle_name": "DIONE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "616-994-3389",
        "authorized_official_credential": "LLP"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.