Michael M Makedonsky, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

000656 Issued in MI

Practice address

3501 Lake Eastbrook Blvd SE
Suite 222
Grand Rapids, MI 49546-5940

Phone

(616) 957-0730

Fax

(616) 957-1057

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Michael Makedonsky PHD

  • Clinical Psychologist
  • Grand Rapids, MI
  • NPI 1811160476
  NPD (past) Authorized official

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1760466056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1767",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495011767",
            "telephone_number": "616-235-2090",
            "fax_number": "616-235-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE",
            "address_2": "SUITE 222",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465940",
            "telephone_number": "616-957-0730",
            "fax_number": "616-957-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKEDONSKY",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "000656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela H Mairs, MA
• Albert Aswani Majani, TBIS
• Anna Majeske
• Hannah Majeske
• Nedila K Major-Babcock, LPN
• Steven J Maki
• Hyder Habib Makki, D.O.
• Serena Makki
• Vicki Marie Makley, SOCIAL WORKER
• Igor Makovey, D.D.S., M.D.

• Clinical Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.