Organization · Type 2 NPI

Mindmap

Clinical Psychologist · Grand Rapids, MI

NPI number 1619840568 Active

Practice location

2020 Raybrook St SE Ste 308
Grand Rapids, MI 49546-7717

Fax (616) 259-4206

Specialties and licenses

Taxonomy	Code	License
Clinical Neuropsychologist	103G00000X	None listed
Clinical Psychologist Primary	103TC0700X	None listed

Clinical Psychologist: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of discip…

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About NPI 1619840568

Mindmap's National Provider Identifier is 1619840568, issued on Sep 26, 2025. The primary taxonomy on file is Clinical Psychologist (103TC0700X), and the practice location is in Grand Rapids, MI. The record was last updated on Sep 26, 2025.