Active NPI
Jeffrey Clearwater, M.A. LLP
- Psychologist
- Allegan, MI
National Provider Identifier
1417081217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- JC011643
- Practice address
- 551 Linn St
Suite 230
Allegan, MI 49010-1595 - Phone
- (269) 686-4110
- Fax
- (269) 686-2135
- NPI assigned
- Mar 15, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | JC011643 | MI | Primary |
Addresses
Primary practice location
551 Linn St
Suite 230
Allegan, MI 49010-1595
Mailing address
551 Linn St
Suite 230
Allegan, MI 49010-1595
Phone (269) 686-4110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JC011643 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417081217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "551 LINN ST",
"address_2": "SUITE 230",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490101595",
"telephone_number": "269-686-4110",
"fax_number": "269-686-2135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "551 LINN ST",
"address_2": "SUITE 230",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490101595",
"telephone_number": "269-686-4110",
"fax_number": "269-686-2135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEARWATER",
"first_name": "JEFFREY",
"credential": "M.A. LLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "JC011643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allegan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.