NPIMap

Organization Active NPI

Life Journey PLLC

  • Psychologist
  • Grand Rapids, MI
National Provider Identifier
1538531017
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301016514 Issued in MI
Legal business name
LIFE JOURNEY PLLC
Practice address
2013 East Castle Drive SW
Suite B
Grand Rapids, MI 49508
Phone
(616) 888-1120
Fax
(616) 469-1113
NPI assigned
Oct 23, 2015
Last updated
Jan 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Authorized official

Name
Dr. Urminda Sue Firlan, PHD, DLLPNPI 1629440979
Title
Psychologist
Phone
(616) 901-9507

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301016514 MI Primary
Cognitive & Behavioral Psychologist 103TB0200X 6301016514 MI
Clinical Psychologist 103TC0700X 6301016514 MI
Counseling Psychologist 103TC1900X 6301016514 MI
Forensic Psychologist 103TF0200X 6301016514 MI
Group Psychotherapy Psychologist 103TP2701X 6301016514 MI
Rehabilitation Psychologist 103TR0400X 6301016514 MI
Marriage & Family Therapist 106H00000X 6301016514 MI

Addresses

Primary practice location

2013 East Castle Drive SW
Suite B
Grand Rapids, MI 49508

Mailing address

2013 East Castle Drive SW
Suite B
Grand Rapids, MI 49508
Phone (616) 888-1060

Other practice location 1

251 N Rose St Ste 200
Kalamazoo, MI 49007-3860
Phone (616) 888-1120

Other practice location 2

11555 W Grand River Ave
Lowell, MI 49331-8464
Phone (616) 888-1120

Other practice location 3

420 Plymouth Ave NE
Grand Rapids, MI 49505-6028
Phone (616) 888-1120

Other practice location 4

3795 Hilton Ave SE
Lowell, MI 49331-9527
Phone (616) 901-9507

Other names 1

  • Life Journey Psychological Services Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200507000643 MI Part B Supplier - Clinic/Group Practice 4688005697 Receives reassigned benefits from 1 practitioner
Practice locations: Battle Creek, MI; Grand Rapids, MI; Holt, MI; Kalamazoo, MI; Lowell, MI

National Provider Directory

National Provider Directory

Locations

11282 Tallmadge Woods Dr NW
Ste A
Grand Rapids, MI 49534

420 Plymouth Ave NE
Grand Rapids, MI 49505

4880 36th St SE
Ste 204
Grand Rapids, MI 49512

2013 Eastcastle Dr SE
Ste B
Kentwood, MI 49508
Phone (616) 204-0308

Practitioners & affiliated clinicians

Practitioners 116

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 116

NPI Registry JSON

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579824000000",
    "number": "1538531017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 EAST CASTLE DRIVE SW",
            "address_2": "SUITE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49508",
            "telephone_number": "616-888-1060",
            "fax_number": "616-469-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 EAST CASTLE DRIVE SW",
            "address_2": "SUITE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49508",
            "telephone_number": "616-888-1120",
            "fax_number": "616-469-1113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 N Rose St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490073860",
            "country_code": "US",
            "telephone_number": "616-888-1120",
            "fax_number": "616-469-1113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11555 W Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "MI",
            "postal_code": "493318464",
            "country_code": "US",
            "telephone_number": "616-888-1120",
            "fax_number": "616-469-1113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 Plymouth Ave NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495056028",
            "country_code": "US",
            "telephone_number": "616-888-1120",
            "fax_number": "616-469-1113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3795 Hilton Ave SE",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "MI",
            "postal_code": "493319527",
            "country_code": "US",
            "telephone_number": "616-901-9507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFE JOURNEY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-23",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "FIRLAN",
        "authorized_official_first_name": "URMINDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "616-901-9507",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, DLLP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301016514",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6301016514",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016514",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301016514",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MI",
            "license": "6301016514",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MI",
            "license": "6301016514",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "MI",
            "license": "6301016514",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "6301016514",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Journey Psychological Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Life Journey Psychological Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jan 24, 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.