Great Lakes Behavioral Health PLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

GREAT LAKES BEHAVIORAL HEALTH PLC

Practice address

678 Front Ave NW
Suite 365
Grand Rapids, MI 49504-5325

Phone

(616) 920-1816

NPI assigned

Feb 26, 2015

Last updated

Jun 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Vander Velde, DONPI 1396743084

Title

Owner

Phone

(616) 920-1816

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• David Dirk Vander Velde, DO

  • Psychiatry Physician
  • Grand Rapids, MI
  • NPI 1396743084
  Authorized official Same address or phone

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433203200000",
    "number": "1609268754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 FRONT AVE NW",
            "address_2": "SUITE 365",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045325",
            "telephone_number": "616-920-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 FRONT AVE NW",
            "address_2": "SUITE 365",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045325",
            "telephone_number": "616-920-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES BEHAVIORAL HEALTH PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-06-02",
        "status": "A",
        "authorized_official_last_name": "VANDER VELDE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-920-1816",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Grayburn, D.O.
• Baylie Grayeb
• Amelia Rose Grayson, DNP, NP-C
• Charles E. Grayson, PH.D.
• Jesse Grazewski
• Great Lakes Chiropractic Partners (Great Lakes Functional Neurology)
• Great Lakes Dental Care P.C.
• Great Lakes Hearing
• Great Lakes Jaw Surgery, PC
• Great Lakes Neurosurgical Associates, PC

• Psychiatry Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; 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.