Organization Active NPI

Midwest Neurobehavioral Center PC

  • Psychologist
  • Saint Joseph, MI
National Provider Identifier
1689465098
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MIDWEST NEUROBEHAVIORAL CENTER PC
Practice address
521 State St
Saint Joseph, MI 49085-1369
Phone
(269) 841-5537
NPI assigned
May 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Authorized official

Name
Danica Overton, PSY.NPI 1316754328
Title
Owner
Phone
(269) 841-5537

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 Primary

Addresses

Primary practice location

521 State St
Saint Joseph, MI 49085-1369

Mailing address

2800 S Lakeshore Dr
Saint Joseph, MI 49085-2932
Phone (269) 841-5537

Other practice location 1

501 W Ogden Ave Ste 1
Hinsdale, IL 60521-3184
Phone (630) 473-4770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250821000865 MI Part B Supplier - Clinic/Group Practice 5395245732 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Joseph, MI
O20250915002922 IL Part B Supplier - Clinic/Group Practice 5395245732 Receives reassigned benefits from 2 practitioners
Practice locations: Hinsdale, IL

National Provider Directory

National Provider Directory

Locations

501 W Ogden Ave
Ste 1
Hinsdale, IL 60521
Phone (630) 986-0599

521 State St
#1
Saint Joseph, MI 49085

521 State St
Saint Joseph, MI 49085
Phone (269) 408-6031

Practitioners & affiliated clinicians

Practitioners 3

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": "1747180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1689465098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 S LAKESHORE DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852932",
            "telephone_number": "269-841-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 STATE ST",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851369",
            "telephone_number": "269-841-5537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 W Ogden Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605213184",
            "country_code": "US",
            "telephone_number": "630-473-4770",
            "fax_number": "269-883-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST NEUROBEHAVIORAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-14",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "OVERTON",
        "authorized_official_first_name": "DANICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-841-5537",
        "authorized_official_credential": "PSY."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.