Active NPI
Mary I. Oppenhuizen, ED.D.
- Counseling Psychologist
- Grand Rapids, MI
National Provider Identifier
1609924141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Practice address
- 2025 E Beltline Ave SE
Ste 102
Grand Rapids, MI 49546-7673 - Phone
- (616) 690-4477
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- 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 | MI | Primary |
Addresses
Primary practice location
2025 E Beltline Ave SE
Ste 102
Grand Rapids, MI 49546-7673
Mailing address
2025 E Beltline Ave SE
Ste 102
Grand Rapids, MI 49546-7673
Phone (616) 690-4477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680D146 040 | Other | MI | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Marcia Hollingsworth, Ed.D, PLLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinical Psychologist
- Grand Rapids, MI
- NPI 1366835589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554940800000",
"number": "1609924141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 E BELTLINE AVE SE",
"address_2": "STE 102",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495467673",
"telephone_number": "616-690-4477",
"fax_number": "616-957-1438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 E BELTLINE AVE SE",
"address_2": "STE 102",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495467673",
"telephone_number": "616-690-4477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPPENHUIZEN",
"first_name": "MARY",
"middle_name": "I.",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2019-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "680D146 040",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
- Robert Oostveen, MD
- Briana M Ophoff, PA-C
- David Mark Ophoff, PA
- Natalie Sue Ophoff
- Cindy Opolka, M.D.
- Andrew James Opperman
- Barbara C Opperwall, NP
- Optalis Beltline Opco, LLC (Optalis Health & Rehabilitation at Kent-Crossing)
- Optalis Grand Rapids MC Opco LLC
- Optalis Grand Rapids Opco LLC (Optalis Health and Rehabilitation of Grand Rapids)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.