Individual provider Active NPI

Ryan A Duckworth, PSYD

  • Clinical Psychologist
  • Holland, MI
National Provider Identifier
1740680883
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301016570 Issued in MI
Practice address
503 Century LN Ste 2
Holland, MI 49423-4318
Phone
(616) 795-0298
Fax
(616) 834-0446
NPI assigned
Aug 26, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301016570 MI Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

503 Century LN Ste 2
Holland, MI 49423-4318

Mailing address

503 Century LN Ste 2
Holland, MI 49423-4318
Phone (616) 795-0298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160927002206 MI Practitioner - Clinical Psychologist 2961799440 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope and Wholeness Psychology Center LLCGroup PAC ID 6901175082, 18 clinicians

Practice addresses (Care Compare)

503 Century LN
Suite 2
Holland, MI 49423-4318
Phone (616) 795-0298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301016570MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kristine Koetje Ma, PC CurrentSince Sep 1, 2016 Accepting new patients
Hope & Wholeness Psychology Center, LLC Clinical CurrentSince May 31, 2017 Accepting new patients

Locations

503 Century Ln
Ste 2
Holland, MI 49423
Phone (616) 295-8284

1877 Georgetown Center Dr
Jenison, MI 49428
Phone (616) 287-4330

1388 Baldwin St
Ste A
Jenison, MI 49428
Phone (616) 259-9220

17224 Van Wagoner Rd
Spring Lake, MI 49456
Phone (616) 296-2130

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1740680883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 CENTURY LN STE 2",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234318",
            "telephone_number": "616-795-0298",
            "fax_number": "616-834-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 CENTURY LN STE 2",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234318",
            "telephone_number": "616-795-0298",
            "fax_number": "616-834-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "RYAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016570",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.