Pediatric Psychologists of West Michigan, PLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PEDIATRIC PSYCHOLOGISTS OF WEST MICHIGAN, PLC

Practice address

2090 Celebration Dr NE Ste 212
Grand Rapids, MI 49525-9200

Phone

(616) 262-2494

NPI assigned

Jul 10, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Kelly Anne Griffin, M.A.

Title

Senior Partner

Phone

(616) 262-2494

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1659535540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 CELEBRATION DR NE STE 212",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259200",
            "telephone_number": "616-262-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 CELEBRATION DR NE STE 212",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259200",
            "telephone_number": "616-262-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PSYCHOLOGISTS OF WEST MICHIGAN, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "616-262-2494",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbigal Louise Pecynski
• Maya Pedersen, PHARMD
• Pediatric Dental Specialists of West Michigan
• Pediatric Dentistry of Michigan PLLC
• Pediatric Ophthalmology PC
• Pediatric Speech Services LLC
• Pediatric Surgeons of West Michigan PC
• Maureen Tan Pedres, M.D.
• Dorothy A Pedtke, D.O.
• Realite Lanice Peebles, LBA, BCBA

• Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.