Active NPI
Dennis Edwin Waite, ED.D.
- Counseling Psychologist
- Berrien Springs, MI
National Provider Identifier
1538218110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6301006392
- Practice address
- 5761 Orchard Dr
Berrien Springs, MI 49103-9683 - Phone
- (269) 471-5422
- Fax
- (269) 473-3261
- NPI assigned
- Jan 10, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6301006392 | MI | Primary |
Addresses
Primary practice location
5761 Orchard Dr
Berrien Springs, MI 49103-9683
Mailing address
PO Box 339
Berrien Springs, MI 49103-0339
Phone (269) 471-5422
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0A1-4515 | Other | MI | BLUE CROSS BLUE SHIELD |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100429000877 | MI | Practitioner - Clinical Psychologist | 2668509282 | Practice locations: Saint Joseph, MI; Berrien Springs, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5761 Orchard Dr
Berrien Springs, MI 49103-9683
Phone (269) 471-5422
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1538218110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 339",
"city": "BERRIEN SPRINGS",
"state": "MI",
"postal_code": "491030339",
"telephone_number": "269-471-5422",
"fax_number": "269-473-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5761 ORCHARD DR",
"city": "BERRIEN SPRINGS",
"state": "MI",
"postal_code": "491039683",
"telephone_number": "269-471-5422",
"fax_number": "269-473-3261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITE",
"first_name": "DENNIS",
"middle_name": "EDWIN",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301006392",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0A1-4515",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Berrien Springs, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.