MIDWEST MICHIGAN PSYCHOLOGICAL ASSOCIATES, PLLC (NPI# 1033318340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033318340 |
| Entity Type | Organization |
| Organization Name | MIDWEST MICHIGAN PSYCHOLOGICAL ASSOCIATES, PLLC |
| Practice Address |
811 Sunnyside Dr Suite I Cadillac MI 49601-7002 |
| Practice Telephone | 2318783059 |
| Practice Fax Number | 8662171182 |
| Mailing Telephone | 2318783059 |
| Mailing Fax Number | 8662171182 |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |
| Authorized Official Name | DR. CRAIG ALLEN DERROR (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2318783059 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
6401004326 | MI | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | 6301013463 | MI | Behavioral Health & Social Service Providers |
| Street Address |
811 SUNNYSIDE DR SUITE I |
| City | CADILLAC |
| State | MI |
| Zip Code | 49601-7002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720691983 | Hailey Amlott | Pharmacist | Walgreens 07660, 1220 N. Mitchell Street, Cadillac, MI 49601 | 2020-08-27 |
| 1558901454 | Diane Lyn Stearns | Physical Therapy Assistant | Samaritas Senior Living, 460 Pearl Street, Cadillac, MI 49601 | 2020-01-09 |
| 1902363013 | Marcella Marie Metzger | Pharmacist | 520 Cobb Street, Cadillac, MI 49601 | 2019-02-25 |
| 1558864447 | Tricia Wing | Physical Therapist | 704 Oak Street, Cadillac, MI 49601 | 2018-03-16 |
| 1386174134 | Marjorie Middel | Social Worker | 1909 N. Mitchell Street, Aleda E. Lutz Veterans Affairs Medical Center Cadillac, Cadillac, MI 49601 | 2017-06-14 |
| 1841726171 | T & M Helping Hand | Home Health | 325 Howard St, Cadillac, MI 49601 | 2017-05-05 |
| 1841731486 | Vicki Lynne Schutte | Behavior Technician | 7716 S. 27 Rd, Cadillac, MI 49601 | 2017-03-15 |
| 1518407220 | Rosanne Marie Denny | Behavior Technician | 605 Cadillac Shores Dr #106, Cadillac, MI 49601 | 2017-02-28 |
| 1821495532 | James David Shadoan | Family Medicine | 133 N. Shore Dr E., Cadillac, MI 49601 | 2014-11-24 |
| 1841632007 | Serenity Adult Foster Care Home LLC | Foster Care Agency | 2883 S. 41 Rd., Cadillac, MI 49601 | 2013-07-29 |
| Find all providers in zip 49601 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417572181 | Amy Jo Bruno | Psychologist | 805 S Carmel St, Cadillac, MI 49601-2344 | 2020-06-09 |
| 1023413986 | Leslie Kibbe | Psychologist | 520 Cobb St, Cadillac, MI 49601-2588 | 2014-11-04 |
| 1124458740 | Mary Luchies | Psychologist | 9116 E 13th St, Cadillac, MI 49601 | 2013-11-18 |
| 1952738536 | Tori Lee Osborn | Psychologist | 805 S Carmel St, Cadillac, MI 49601-2344 | 2013-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609072 | George Edward Khamis | Psychologist | 25600 Woodward Avenue, Suite 215, Royal Oak, MI 48067 | 2020-11-05 |
| 1932700036 | Estela M Rivero | Psychologist | 2627 Oak Valley Dr Apt 205, Ann Arbor, MI 48103-7705 | 2020-11-04 |
| 1144829037 | Damon Moore | Psychologist | 15450 E Jefferson Ave Ste 180, Grosse Pointe Park, MI 48230-2031 | 2020-10-21 |
| 1073112355 | Sarah Nicole Kesler | Psychologist | 230 Collingwood St Ste 250, Ann Arbor, MI 48103-3845 | 2020-10-19 |
| 1518564947 | Margaret L Blevins | Psychologist | 21769 Meridian Rd, Grosse Ile, MI 48138-1453 | 2020-10-08 |
| 1770197717 | Susan J Goldberg | Psychologist | 442 Randolph St, Northville, MI 48167-1465 | 2020-09-08 |
| 1255944096 | Eric S. Samson | Psychologist | 2045 E West Maple Rd Ste D405, Commerce Township, MI 48390-3801 | 2020-08-30 |
| 1891308904 | Susan Gottlieb Phd LLC | Psychologist | 23800 Orchard Lake Rd Ste 104, Farmington Hills, MI 48336-2561 | 2020-08-28 |
| 1538784012 | Bethany S Gourley | Psychologist | 19855 Outer Dr Ste 300, Dearborn, MI 48124-2022 | 2020-06-10 |
| 1316560303 | Amy K Pruneau LLC | Psychologist | 26755 Middlebelt Rd Ste 140, Farmington Hills, MI 48334 | 2020-05-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.