Clinical Psychiatric Medicine PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301045669 Issued in MI

Legal business name

CLINICAL PSYCHIATRIC MEDICINE PC

Practice address

0-151 44TH Street SW
Grandville, MI 49418

Phone

(616) 457-1889

Fax

(616) 457-1891

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Nan B Ah, MD

Title

President

Phone

(616) 457-1889

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nan Beth Alt, M.D.

  • Psychiatry Physician
  • Grandville, MI
  • NPI 1417139692
  NPD

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386677185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0-151 44TH STREET SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "49418",
            "telephone_number": "616-457-1889",
            "fax_number": "616-457-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "0-151 44TH STREET SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "49418",
            "telephone_number": "616-457-1889",
            "fax_number": "616-457-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL PSYCHIATRIC MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AH",
        "authorized_official_first_name": "NAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-457-1889",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301045669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3085001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NA045669",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Cin
• Althea Rose Clarey-Schultz
• James Edward Clarey, RPH
• Chaniya Clark, LLBSW
• Randall Norton Clark, MD
• Stephen D Cohle, MD
• Collaborative Counseling Group PLLC
• Alissa Collins
• Jennifer O Collins, PHD
• Elyse Simone Comeau

• Psychiatry Physician in Grandville, MI
• Providers in Grandville, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.