Psychiatric Associates of West Michigan, PLC
Organization Active NPI Medical Specialty Clinic/Center · Saugatuck, MI
NPI 1841480134 · NPPES record last updated Oct 30, 2024
Key facts
- NPI
- 1841480134
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medical Specialty Clinic/Center 261QM2500X
- Legal business name
- PSYCHIATRIC ASSOCIATES OF WEST MICHIGAN, PLC
- Practice address
- 6555 Heron Bay Dr
Saugatuck, MI 49453-9687 - Phone
- (616) 719-4488
- Fax
- (616) 719-4480
- NPI assigned
- Aug 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Valerie Alexander
- Title
- Manager
- Phone
- (616) 735-1505
Practitioners 7
-
Philip S Fox, MD
-
Henry J Mulder, M.D.
-
Barbara E Gritter, LMSW, ACSW
-
Victoria Pelton, MA, LLP, CAADC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051230000259 | MI | Part B Supplier - Clinic/Group Practice | 3072535285 |
Receives reassigned benefits from 2 practitioners Practice locations: Saugatuck, MI |
National Provider Directory
Locations
300 68th St SE
Ste B
Grand Rapids, MI 49548
Phone (616) 281-6345
1403 60th St SE
Kentwood, MI 49508
Phone (616) 485-9561
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | Yes |
Addresses
Primary practice location
6555 Heron Bay Dr
Saugatuck, MI 49453-9687
Mailing address
PO Box 140241
Grand Rapids, MI 49514-0241
Phone (616) 735-1505
Other names
- PAWM
Other providers in Saugatuck, MI
- Lakeshore Pharmacies, Inc.
- James Lynch
- Thomas Francis Mooney
- David Moore
- Eric Kees Peet
- Saugatuck Chiropractic Clinic, LLC
- Rosanne D Vasiloff
- Nathan Daniel Wass
- Christopher B. Wiley
- Wimer Therapy LLC
All providers in Saugatuck, MI · Medical Specialty Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.