Lidderdale Consulting PLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301014348 Issued in MI

Legal business name

LIDDERDALE CONSULTING PLC

Practice address

668 3 Mile Rd NW Ste D
Grand Rapids, MI 49544-8219

Phone

(616) 426-9193

Fax

(616) 426-9455

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Melissa Ann Lidderdale, PHDNPI 1225158306

Title

Psychologist/Owner

Phone

(616) 426-9193

Specialties & licenses 4

Addresses

Other names 1

• Melissa A. Lidderdale, PLC Former legal business name

Tax ID family

Lidderdale Consulting PLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lidderdale Consulting PLC

  • Clinical Psychologist
  • Grand Rapids, MI
  • NPI 1568080687
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa Ann Lidderdale, PHD

  • Clinical Psychologist
  • Grand Rapids, MI
  • NPI 1225158306
  NPD Authorized official

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1871613968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 COURTLAND ST UNIT 794",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493415027",
            "telephone_number": "616-426-9193",
            "fax_number": "616-426-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 3 MILE RD NW STE D",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495448219",
            "telephone_number": "616-426-9193",
            "fax_number": "616-426-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIDDERDALE CONSULTING PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "LIDDERDALE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "616-426-9193",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012277",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014348",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301012277",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301014348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melissa A. Lidderdale, PLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Melissa A. Lidderdale, PLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kimberly Sue Lichon-Tufer, LMSW
• Melissa Lichtenwalter, RN
• Ladonna G Lichterman, CRNA
• Sarah Lickiss, LMSW
• Lidderdale Consulting PLC
• Melissa Ann Lidderdale, PHD
• Amanda Liddicoat, MS, CGC
• Kelsey Lynn Liddil, OTRL
• Laken Liddle
• Jennifer Lieber

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.