Jerry Bernard Vanleeuwen, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301003978 Issued in MI

Practice address

6255 28TH St SE Ste M
Grand Rapids, MI 49546-6966

Phone

(616) 458-5294

Fax

(616) 458-5295

NPI assigned

May 30, 2007

Last updated

Jan 31, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Jerry B. Vanleeuwen Professional name

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

Specialty

Marriage and Family Therapist

Education

Other, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jerry B Vanleeuwen PHD PC

  • Cognitive & Behavioral Psychologist
  • Grand Rapids, MI
  • NPI 1497943146
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1336340140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 28TH ST SE STE M",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466966",
            "telephone_number": "616-458-5294",
            "fax_number": "616-458-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 28TH ST SE STE M",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466966",
            "telephone_number": "616-458-5294",
            "fax_number": "616-458-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLEEUWEN",
        "first_name": "JERRY",
        "middle_name": "BERNARD",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301003978",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MI",
            "license": "4101000398",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "VANLEEUWEN",
            "middle_name": "B.",
            "credential": "PHD, PC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Elizabeth Erin Vanklompenberg, BS
• Emily Joy Vankoevering
• Kelly Vankoevering
• Elba Vankuiken
• Steven John Vanlaan, DO
• Holly Vanlente, RPH
• Philip Vanlente, MD
• Matthew Vanlinden
• William Paul Vanlonkhuyzen, PA-C
• Sheila Marie Vanlowe-Prince, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.