The Shoreline Center LLC
NPI 1942689708ActiveOrganization· Psychologist, Clinical· Grand Haven, MI
Psychologist, Clinical in Grand Haven, Michigan, registered in NPPES in May 2015. The authorized official on file is Dan Radley, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1942689708 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 27, 2015 |
| Last updated in NPPES | Aug 3, 2021 |
| Certified by provider | Aug 3, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 6301014390 | MI |
| Clinic/Center, Developmental Disabilities | 261QD1600X | — | — |
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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