Halee Jordan Grams, TLLP
Individual provider Active NPI Psychologist · Ottawa Lake, MI
NPI 1821616129 · NPPES record last updated Mar 22, 2024
Key facts
- NPI
- 1821616129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 6361007980 (MI)
- Practice address
- 6250 Memorial Hwy
Ottawa Lake, MI 49267-5902 - Phone
- (419) 704-5675
- NPI assigned
- Jul 13, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6361007980 | MI | MD | Psychologist |
| 6301018383 | MI | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lenawee Community Mental Health Authority | Past |
Accepting new patients | |
| Lenawee Community Mental Health Authority | Past |
Accepting new patients | |
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6361007980 | MI | Yes |
| Counseling Psychologist | 103TC1900X | 6301018383 | MI |
Addresses
Primary practice location
6250 Memorial Hwy
Ottawa Lake, MI 49267-5902
Mailing address
6250 Memorial Hwy
Ottawa Lake, MI 49267-5902
Other providers in Ottawa Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.