Mary Jo Baweja, MA, LLP

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6361001393 Issued in MI

Practice address

889 143Rd Ave
Wayland, MI 49348-9758

Phone

(616) 821-1575

NPI assigned

Apr 9, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1649462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649462400000",
    "number": "1376285494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 143RD AVE",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493489758",
            "telephone_number": "616-821-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 143RD AVE",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493489758",
            "telephone_number": "616-821-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAWEJA",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "MA, LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-09",
        "last_updated": "2022-04-09",
        "certification_date": "2022-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6361001393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.google.com",
            "affiliation": "N",
            "endpointDescription": "Computer",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "889 143rd Ave",
            "city": "Wayland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493489758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2022; 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.