Organization Active NPI

Alpha Psychological Services of Western Michigan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muskegon, MI
National Provider Identifier
1811291990
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
6301006533 Issued in MI
Legal business name
ALPHA PSYCHOLOGICAL SERVICES OF WESTERN MICHIGAN
Practice address
1804 Oak Ave
Muskegon, MI 49442-2408
Phone
(231) 773-8093
Fax
(231) 773-8952
NPI assigned
Jan 4, 2011
Last updated
Mar 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

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

Authorized official

Name
Dr. Allan Warren Crummett, ED.D.NPI 1356312276
Title
Licensed Psychologist
Phone
(231) 773-8093

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 6301006533 MI Primary

Addresses

Primary practice location

1804 Oak Ave
Muskegon, MI 49442-2408

Mailing address

1804 Oak Ave
Muskegon, MI 49442-2408
Phone (231) 773-8093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110105000305 MI Part B Supplier - Clinic/Group Practice 0648469742 Receives reassigned benefits from 1 practitioner
Practice locations: Muskegon, MI

National Provider Directory

National Provider Directory

Locations

1804 Oak Ave
Muskegon, MI 49442
Phone (231) 773-8093

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": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1811291990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 OAK AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494422408",
            "telephone_number": "231-773-8093",
            "fax_number": "231-773-8952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 OAK AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494422408",
            "telephone_number": "231-773-8093",
            "fax_number": "231-773-8952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA PSYCHOLOGICAL SERVICES OF WESTERN MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "CRUMMETT",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "231-773-8093",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MI",
            "license": "6301006533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.