Raymond Paul Herzog, MA, LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301011394 Issued in MI

Practice address

1013 Parchment Dr SE
Grand Rapids, MI 49546-3664

Phone

(616) 974-0901

Fax

(616) 974-0923

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1669400107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 PARCHMENT DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463664",
            "telephone_number": "616-974-0901",
            "fax_number": "616-974-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 PARCHMENT DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463664",
            "telephone_number": "616-974-0901",
            "fax_number": "616-974-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "RAYMOND",
        "middle_name": "PAUL",
        "credential": "MA, LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301011394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P10C976540",
            "identifier": "BC/BS",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Herrington
• Samantha Lynn Herrmann
• Lael Katherine Herron
• Rebecca Anne Hershman, LMSW
• Mary A Herzog, MD
• Abigail Ellen Hescott, DPT
• Michelle Christine Heslinga, LMSW
• John E. Heslip, M.D.
• Erin Elizabeth Hess-Eising, MSW LCSW
• Abigail Jeanne Hess, R.D.

• 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 Jan 30, 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.