Wilson and Wynn Interventions, PLC

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

6301008405 Issued in MI

Legal business name

WILSON AND WYNN INTERVENTIONS, PLC

Practice address

4519 Cascade Rd SE Ste 6
Grand Rapids, MI 49546-8319

Phone

(616) 647-3460

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Sandra Jean Wynn-Stelt

Title

Co-Owner

Phone

(616) 647-3460

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 7

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

• Jennifer Marie Barabas, LMSW

  • Clinical Social Worker
  • Holland, MI
  • NPI 1669884169
  Medicare reassignment NPD
• Theresa Lynn Bundy-Pham

  • Social Worker
  • Grand Rapids, MI
  • NPI 1679801179
  NPD (past)
• Stephanie Exton, MS

  • Case Manager/Care Coordinator
  • Grand Rapids, MI
  • NPI 1386017499
  NPD (past)
• Carrie Louise Labarge, DOULA, LCE, CBS, RYT

  • Lactation Consultant (Non-RN)
  • Coral, MI
  • NPI 1427288000

  Single Specialty

  NPD (past)
• Kimberly Sue Lichon-Tufer, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1265974976
  NPD (past)
• Matthew R Monahan-Reed, MA, LPC, BCBA

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1891180063
  NPD (past)
• Julia Lynn Vandenbosch, LMSW

  • Clinical Social Worker
  • Kentwood, MI
  • NPI 1215110887
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1598810137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10843 CRAWFORD LAKE TRL",
            "city": "CEDAR SPRINGS",
            "state": "MI",
            "postal_code": "493198771",
            "telephone_number": "616-647-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 CASCADE RD SE STE 6",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468319",
            "telephone_number": "616-647-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON AND WYNN INTERVENTIONS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "WYNN-STELT",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "616-647-3460"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6301008405",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6301012332",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301008405",
            "primary": true
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301012332",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801083017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigayle Willock
• Willow Counseling Studio
• Willow Waters Therapy
• Anna Laurine Wills
• Wilson and Wynn Interventions
• Wilson Dental Care GR PC
• Wilson Psychological Services PLLC
• Tori C Wilson-Richardson
• Aimee Lynn Wilson, D.O.
• Amanda Wilson

• Intellectual & Developmental Disabilities Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Intellectual & Developmental Disabilities Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.