Organization Active NPI

Child & Family Psychological Services, P.C.

  • Counseling Psychologist
  • Kalamazoo, MI
National Provider Identifier
1366710774
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6301008415 Issued in MI
Legal business name
CHILD & FAMILY PSYCHOLOGICAL SERVICES, P.C.
Practice address
5340 Holiday Ter
Kalamazoo, MI 49009-2196
Phone
(269) 372-4140
NPI assigned
Dec 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Nicole McGruder
Title
Practice Manager
Phone
(269) 372-4140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X 6301008415 MI Primary

Addresses

Primary practice location

5340 Holiday Ter
Kalamazoo, MI 49009-2196

Mailing address

5340 Holiday Ter
Kalamazoo, MI 49009-2196
Phone (269) 372-4140

Other practice location 1

1662 E Centre Ave
Portage, MI 49002-4496
Phone (269) 321-8564

Other names 1

  • Child and Family Psychological Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Child and Family Psychological Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1366710774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 HOLIDAY TER",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092196",
            "telephone_number": "269-372-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 HOLIDAY TER",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092196",
            "telephone_number": "269-372-4140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1662 E Centre Ave",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490024496",
            "country_code": "US",
            "telephone_number": "269-321-8564",
            "fax_number": "269-321-8641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHILD & FAMILY PSYCHOLOGICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "MCGRUDER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "269-372-4140"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301008415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child and Family Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.