NPIMap

Organization Active NPI

Heart'S Journey Wellness Center, LLC

  • Clinical Psychologist
  • Allendale, MI
National Provider Identifier
1619214699
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301013131 Issued in MI
Legal business name
HEART'S JOURNEY WELLNESS CENTER, LLC
Practice address
6189 Lake Michigan Dr
Allendale, MI 49401-9244
Phone
(616) 307-1617
Fax
(616) 588-6046
NPI assigned
Jan 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Authorized official

Name
Dr. Susan Marie Dilsworth, PHDNPI 1063719037
Title
Owner/Clinician
Phone
(616) 307-1617

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301013131 MI Primary

Addresses

Primary practice location

6189 Lake Michigan Dr
Allendale, MI 49401-9244

Mailing address

6189 Lake Michigan Dr
Allendale, MI 49401-9244
Phone (616) 307-1617

National Provider Directory

National Provider Directory
Tax ID family
Heart'S Journey Wellness Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1619214699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6189 LAKE MICHIGAN DR",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019244",
            "telephone_number": "616-307-1617",
            "fax_number": "616-588-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6189 LAKE MICHIGAN DR",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019244",
            "telephone_number": "616-307-1617",
            "fax_number": "616-588-6046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART'S JOURNEY WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "DILSWORTH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "616-307-1617",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allendale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.