NPIMap

Organization Active NPI

Radical Health & Wellness

  • Cognitive & Behavioral Psychologist
  • Alto, MI
National Provider Identifier
1720529779
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
6301016125 Issued in MI
Legal business name
RADICAL HEALTH & WELLNESS
Practice address
8655 Whitneyville CT SE
Alto, MI 49302-9785
Phone
(269) 692-5321
Fax
(269) 312-7328
NPI assigned
Mar 10, 2017
Last updated
Jun 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Authorized official

Name
Dr. Heather J Dannison, PHD, LPNPI 1679985873
Title
Counseling Psychologist
Phone
(269) 692-5321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TB0200X 6301016125 MI Primary

Addresses

Primary practice location

8655 Whitneyville CT SE
Alto, MI 49302-9785

Mailing address

8655 Whitneyville CT SE
Alto, MI 49302-9785
Phone (269) 692-5321

Other practice location 1

604 S Rose St
Kalamazoo, MI 49007
Phone (269) 692-5321

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1720529779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8655 WHITNEYVILLE CT SE",
            "city": "ALTO",
            "state": "MI",
            "postal_code": "493029785",
            "telephone_number": "269-692-5321",
            "fax_number": "269-312-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8655 WHITNEYVILLE CT SE",
            "city": "ALTO",
            "state": "MI",
            "postal_code": "493029785",
            "telephone_number": "269-692-5321",
            "fax_number": "269-312-7328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 S Rose St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "49007",
            "country_code": "US",
            "telephone_number": "269-692-5321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RADICAL HEALTH & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "DANNISON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COUNSELING PSYCHOLOGIST",
        "authorized_official_telephone_number": "269-692-5321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LP"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6301016125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alto, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.