NPIMap

Organization Active NPI

Wilson Psychological Services PLLC

  • Psychologist
  • Grand Rapids, MI
National Provider Identifier
1528558574
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
WILSON PSYCHOLOGICAL SERVICES PLLC
Practice address
5001 Plainfield Ave NE Ste B
Grand Rapids, MI 49525-1050
Phone
(616) 600-1667
Fax
(616) 805-3613
NPI assigned
May 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

Name
Jamie Wilson, LLPNPI 1770913832
Title
President / Therapist
Phone
(616) 600-1667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X

Addresses

Primary practice location

5001 Plainfield Ave NE Ste B
Grand Rapids, MI 49525-1050

Mailing address

5001 Plainfield Ave NE Ste B
Grand Rapids, MI 49525-1050
Phone (616) 600-1667

National Provider Directory

National Provider Directory

Locations

5001 Plainfield Ave NE
Ste B
Grand Rapids, MI 49525
Phone (616) 600-1667

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1528558574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 PLAINFIELD AVE NE STE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251050",
            "telephone_number": "616-600-1667",
            "fax_number": "616-805-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 PLAINFIELD AVE NE STE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251050",
            "telephone_number": "616-600-1667",
            "fax_number": "616-805-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "PRESIDENT / THERAPIST",
        "authorized_official_telephone_number": "616-600-1667",
        "authorized_official_credential": "LLP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.