NPIMap

Organization Active NPI

Ronan Psychological Associates, LLC

  • Clinical Psychologist
  • Mt Pleasant, MI
National Provider Identifier
1306905625
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301007695 Issued in MI
Legal business name
RONAN PSYCHOLOGICAL ASSOCIATES, LLC
Practice address
411 W Broadway St
Mt Pleasant, MI 48858-2444
Phone
(989) 779-8999
Fax
(989) 419-5953
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Authorized official

Name
Amy Perschbacher, LPC, NCC, ACSNPI 1861944464
Title
Owner
Phone
(989) 779-8999

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301007695 MI Primary

Addresses

Primary practice location

411 W Broadway St
Mt Pleasant, MI 48858-2444

Mailing address

411 W Broadway St
Mt Pleasant, MI 48858-2444
Phone (989) 779-8999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230119000670 MI Part B Supplier - Clinic/Group Practice 6901277557 Receives reassigned benefits from 11 practitioners
Practice locations: Mt Pleasant, MI

National Provider Directory

National Provider Directory

Locations

311 W Broadway St
Ste 4
Mt Pleasant, MI 48858
Phone (989) 779-8999

Practitioners & affiliated clinicians

Practitioners 11

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": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1306905625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W BROADWAY ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582444",
            "telephone_number": "989-779-8999",
            "fax_number": "989-419-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W BROADWAY ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582444",
            "telephone_number": "989-779-8999",
            "fax_number": "989-419-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONAN PSYCHOLOGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "PERSCHBACHER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-779-8999",
        "authorized_official_credential": "LPC, NCC, ACS"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.