Larry R Teitsma, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301001766 Issued in MI

Practice address

3330 Claystone St SE
Grand Rapids, MI 49546-7716

Phone

(616) 942-8060

Fax

(616) 942-6690

NPI assigned

Feb 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Claystone Clinical Associates PLC

  • Psychiatry Physician
  • Grand Rapids, MI
  • NPI 1336668698
  NPD (past)
• Claystone Clinical Associates PLC

  • Psychiatry Physician
  • Grand Rapids, MI
  • NPI 1619927142

  Clinical

  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1295707412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016",
            "telephone_number": "616-532-8000",
            "fax_number": "616-532-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 CLAYSTONE ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467716",
            "telephone_number": "616-942-8060",
            "fax_number": "616-942-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEITSMA",
        "first_name": "LARRY",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301001766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly Germaine Teesdale, MSOTR/L
• Jenna Teeter, BS
• Kelly S Teft, PA-C
• Morad M Tehrani, MD
• Erin N Teitsma, PA-C
• Zachary Frens Teitsma, BA
• Linda Tejada
• Reyna Tejeda-Woodard
• Sololeya Teklehaimanot
• Courtney Telfer, NP-C

• Clinical Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.