Individual provider Active NPI

Alexander Sydney Houseknecht, PH.D., LP

  • Counseling Psychologist
  • Grand Rapids, MI
National Provider Identifier
1609416197
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6301019486 Issued in MI
Practice address
1514 Wealthy St SE Ste 290
Grand Rapids, MI 49506-2755
Phone
(206) 465-3302
NPI assigned
Jan 13, 2020
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6301018243 MI
Counseling Psychologist 103TC1900X 6352000108 MI
Counseling Psychologist 103TC1900X 6301019486 MI Primary

Addresses

Primary practice location

1514 Wealthy St SE Ste 290
Grand Rapids, MI 49506-2755

Mailing address

337 Visser PL SE
Grand Rapids, MI 49506-1541

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260521004095 MI Practitioner - Psychologist Billing Independently 1850861600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1514 Wealthy St SE
Suite 290
Grand Rapids, MI 49506-2755

7108 Curtis Dr
Dardenne Prairie, MO 63368-9619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301018243MIMDCounseling Psychologist
6301019486MIMDCounseling Psychologist
6352000108MIMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Houseknecht Psychological Services, LLC Current Accepting new patients

Locations

1514 Wealthy St SE
Ste 290
Grand Rapids, MI 49506
Phone (616) 706-4765

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1609416197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 VISSER PL SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 WEALTHY ST SE STE 290",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062755",
            "telephone_number": "206-465-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSEKNECHT",
        "first_name": "ALEXANDER",
        "middle_name": "SYDNEY",
        "credential": "PH.D., LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-13",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301018243",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6352000108",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301019486",
            "primary": true
        }
    ],
    "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 Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.