Psychology Associates of Grand Rapids PC
NPI 1205017738ActiveOrganization· Psychologist· Grand Rapids, MI
Psychologist in Grand Rapids, Michigan, registered in NPPES in November 2007. The authorized official on file is Craig A. De Witt, PSY.D., Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1205017738 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 27, 2007 |
| Last updated in NPPES | Mar 9, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
| Psychiatry & Neurology, Psychiatry | 2084P0800X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
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