River Way Psychological Services

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

RIVER WAY PSYCHOLOGICAL SERVICES

Practice address

975 Spaulding Ave SE Ste D
Ada, MI 49301-3776

Phone

(231) 881-2416

NPI assigned

Dec 16, 2019

Organization subpart

No

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

Authorized official

Name

Cheryl Elaine Samuels, PHDNPI 1205042827

Title

Owner

Phone

(231) 881-2416

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Cheryl E Samuels, PH.D.

  • Clinical Psychologist
  • Ada, MI
  • NPI 1205042827
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1407494982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 213",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494680213",
            "telephone_number": "231-881-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SPAULDING AVE SE STE D",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493013776",
            "telephone_number": "231-881-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER WAY PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-16",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "SAMUELS",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-881-2416",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "fax",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "975 Spaulding Ave SE Ste D",
            "city": "Ada",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493013776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rhonda Densborn LLC
• Rhonda Densborn LLC
• Rhonda Densborn LLC
• Joan Marie Rider-Becker, PHARMD/CDE
• River City Dermatology PLLC
• Jeremy B Roark, PH.D.
• Melissa Britton Roberts, RN
• Hilary Rogers
• Daniel Rosen, ED.D, ABPP
• Barbara Kay Rush-Rounds, O.T.R.

• Clinical Psychologist in Ada, MI
• Providers in Ada, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.