Individual provider Active NPI

Brett Cornell Vantol, PHD

  • Group Psychotherapy Psychologist
  • Lansing, MI
National Provider Identifier
1942389481
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
Practice address
3960 Patient Care Way
Suite 104
Lansing, MI 48911-4275
Phone
(517) 887-9801
Fax
(517) 887-9826
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X
Psychologist 103T00000X 6301008897 MI
Group Psychotherapy Psychologist 103TP2701X Primary
Rehabilitation Psychologist 103TR0400X

Addresses

Primary practice location

3960 Patient Care Way
Suite 104
Lansing, MI 48911-4275

Mailing address

3960 Patient Care Way
Suite 104
Lansing, MI 48911-4275
Phone (517) 887-9801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041013000414 MI Practitioner - Clinical Psychologist 6305806597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pine Rest Christian Mental Health ServicesGroup PAC ID 4981506508, 354 clinicians

Practice addresses (Care Compare)

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301008897MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services Psychologist CurrentSince Sep 18, 2008 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Sep 18, 2008 Accepting new patients

Locations

17325 Van Wagoner Rd
Spring Lake, MI 49456
Phone (616) 846-9100

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1942389481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 PATIENT CARE WAY",
            "address_2": "SUITE 104",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114275",
            "telephone_number": "517-887-9801",
            "fax_number": "517-887-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 PATIENT CARE WAY",
            "address_2": "SUITE 104",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114275",
            "telephone_number": "517-887-9801",
            "fax_number": "517-887-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTOL",
        "first_name": "BRETT",
        "middle_name": "CORNELL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301008897",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.