Individual provider Active NPI

Brandon C Ehle, PSYD LP

  • Clinical Psychologist
  • Grand Rapids, MI
National Provider Identifier
1447327655
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301013389 Issued in MI
Practice address
5250 Northland Drive Suite a
North Kent Guidance Services LLC
Grand Rapids, MI 49525-1040
Phone
(616) 361-5001
Fax
(616) 631-2166
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301013389 MI Primary
Psychologist 103T00000X 6301013389 MI

Addresses

Primary practice location

5250 Northland Drive Suite a
North Kent Guidance Services LLC
Grand Rapids, MI 49525-1040

Mailing address

5250 Northland Drive Suite a
North Kent Guidance Services LLC
Grand Rapids, MI 49525-1040
Phone (616) 361-5001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100915000703 MI Practitioner - Clinical Psychologist 6103941067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5250 Northland Dr NE
Grand Rapids, MI 49525-1096
Phone (616) 361-5001

5250 Northland Dr NE a
Grand Rapids, MI 49525-1040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1447327655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 NORTHLAND DRIVE SUITE A",
            "address_2": "NORTH KENT GUIDANCE SERVICES LLC",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251040",
            "telephone_number": "616-361-5001",
            "fax_number": "616-631-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 NORTHLAND DRIVE SUITE A",
            "address_2": "NORTH KENT GUIDANCE SERVICES LLC",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251040",
            "telephone_number": "616-361-5001",
            "fax_number": "616-631-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLE",
        "first_name": "BRANDON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PSYD LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013389",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013389",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.