Individual provider Active NPI

Angela Ann Musselman, L.L.P.

  • Psychologist
  • Grand Rapids, MI
National Provider Identifier
1184845455
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301009957 Issued in MI
Practice address
80 68TH St SE
Suite 300
Grand Rapids, MI 49548-6980
Phone
(616) 292-1995
Fax
(616) 827-2277
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301009957 MI Primary

Addresses

Primary practice location

80 68TH St SE
Suite 300
Grand Rapids, MI 49548-6980

Mailing address

PO Box 519
Byron Center, MI 49315-0519
Phone (616) 292-1995

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

LicenseStateTypeSpecialty
6301009957MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro-Active Counseling LLC Psychologist PastSince Mar 9, 2020 Accepting new patients

Organizations & group practices 1

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184845455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 519",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493150519",
            "telephone_number": "616-292-1995",
            "fax_number": "616-827-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 68TH ST SE",
            "address_2": "SUITE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486980",
            "telephone_number": "616-292-1995",
            "fax_number": "616-827-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSELMAN",
        "first_name": "ANGELA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "L.L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301009957",
            "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 Jul 8, 2007; 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.