NPIMap

Organization Active NPI

Sean W Harrell

  • Psychologist
  • Grand Rapids, MI
National Provider Identifier
1679938310
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301016096 Issued in MI
Legal business name
SEAN W HARRELL
Practice address
3501 Lake Eastbrook Blvd SE
Ste 280
Grand Rapids, MI 49546
Phone
(616) 264-5032
Fax
(517) 323-9531
NPI assigned
Dec 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Authorized official

Name
Sean W Harrell, PSYCHOLOGISTNPI 1679984132
Title
Owner
Phone
(616) 264-5032

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
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 6301016096 MI Primary

Addresses

Primary practice location

3501 Lake Eastbrook Blvd SE
Ste 280
Grand Rapids, MI 49546

Mailing address

351 Lake Eastbrook Blvd SE
Ste 280
Grand Rapids, MI 49546
Phone (616) 264-5032

National Provider Directory

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": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1679938310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 LAKE EASTBROOK BLVD SE",
            "address_2": "STE 280",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-264-5032",
            "fax_number": "517-323-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE",
            "address_2": "STE 280",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-264-5032",
            "fax_number": "517-323-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAN W HARRELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-264-5032",
        "authorized_official_credential": "PSYCHOLOGIST"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301016096",
            "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 Dec 23, 2015; 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.