Individual provider Active NPI

Marianne Dunn, PSY.D.

  • Clinical Psychologist
  • Grand Rapids, MI
National Provider Identifier
1174740088
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301007526 Issued in MI
Practice address
2894 Thornapple River Dr SE
Grand Rapids, MI 49546-6857
Phone
(616) 285-6080
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301007526 MI Primary

Addresses

Primary practice location

2894 Thornapple River Dr SE
Grand Rapids, MI 49546-6857

Mailing address

4467 Cascade Rd SE Ste 4469
Grand Rapids, MI 49546-3776

Other identifiers 1

IdentifierTypeStateIssuer
680D146140OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070613000512 MI Practitioner - Clinical Psychologist 5092813162 Reassigns benefits to 1 organization
Practice locations: Grand Rapids, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4467 Cascade Rd SE
Suite 4469
Grand Rapids, MI 49546-3776
Phone (616) 818-9957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dunn Psychological Services LLC CurrentSince Nov 25, 2023 Accepting new patients
William Parker PHD PC Clinical Past Accepting new patients

Locations

4467 Cascade Rd SE
Ste A4469
Grand Rapids, MI 49546
Phone (248) 259-1868

4467 Cascade Rd SE
#4469
Grand Rapids, MI 49546
Phone (616) 818-9957

4467 Cascade Rd SE
Ste 4469
Grand Rapids, MI 49546
Phone (616) 209-8862

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1174740088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4467 CASCADE RD SE STE 4469",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2894 THORNAPPLE RIVER DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466857",
            "telephone_number": "616-285-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "MARIANNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "680D146140",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.