NPIMap

Organization Active NPI

Claystone Clinical Associates PLC

  • Psychiatry Physician
  • Grand Rapids, MI
National Provider Identifier
1336668698
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CLAYSTONE CLINICAL ASSOCIATES PLC
Practice address
2401 Camelot CT SE Ste E
Grand Rapids, MI 49546-6083
Phone
(616) 648-2289
Fax
(616) 949-3018
NPI assigned
Sep 18, 2017
Last updated
May 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Carole Chisholm, MSWNPI 1356312474
Title
Ceo
Phone
(616) 949-7460

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
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2401 Camelot CT SE Ste E
Grand Rapids, MI 49546-6083

Mailing address

2401 Camelot CT SE Ste E
Grand Rapids, MI 49546-6083
Phone (616) 949-7460

National Provider Directory

National Provider Directory

Locations

2040 Raybrook St SE
Ste 300
Grand Rapids, MI 49546
Phone (616) 285-6777

2401 Camelot Ct SE
Ste E
Grand Rapids, MI 49546
Phone (616) 648-2289

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1336668698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 CAMELOT CT SE STE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466083",
            "telephone_number": "616-949-7460",
            "fax_number": "616-949-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 CAMELOT CT SE STE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466083",
            "telephone_number": "616-648-2289",
            "fax_number": "616-949-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYSTONE CLINICAL ASSOCIATES PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "CHISHOLM",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-949-7460",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "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 May 23, 2024; 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.