JON S BOS (NPI# 1922123645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922123645 |
| Entity Type | Individual |
| Full Name | JON S BOS |
| Credential | PSY.D. |
| Practice Address |
640 3 Mile Rd Nw Suite 101 Grand Rapids MI 49544-8209 |
| Practice Telephone | 6167858900 |
| Practice Fax Number | 6167858949 |
| Mailing Telephone | 6167858900 |
| Mailing Fax Number | 6167858949 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 6301010098 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS PROVIDER I.D. | 680D116880 | 01 |
| Street Address |
640 3 MILE RD NW SUITE 101 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49544-8209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518971795 | William Charles Padding | Social Worker | 640 3 Mile Rd Nw, Suite 101, Grand Rapids, MI 49544-8209 | 2006-07-27 |
| 1295072320 | Cynthia L Kimball, Lmsw, Acsw, Achp-sw, Plc | Social Worker | 640 3 Mile Rd Nw, Suite 101, Grand Rapids, MI 49544-8209 | 2013-01-09 |
| 1396081253 | William C Padding, Lmsw, Acsw, PC | Social Worker | 640 3 Mile Rd Nw, Suite 101, Grand Rapids, MI 49544-8209 | 2012-12-21 |
| 1699010298 | Cynthia Louise Kimball | Social Worker | 640 3 Mile Rd Nw, Suite 101, Grand Rapids, MI 49544-8209 | 2012-12-07 |
| 1588994701 | Jessica Marie Cloutier | Counselor | 640 3 Mile Rd Nw, Grand Rapids, MI 49544-8209 | 2010-01-11 |
| 1073648960 | Rhonda Anne Hill | Counselor | 640 3 Mile Rd Nw, Suite 101, Grand Rapids, MI 49544-8209 | 2007-02-22 |
| 1649378050 | Margaret Ruth Kos | Counselor | 640 3 Mile Rd Nw, Suite 101, Grand Rapids, MI 49544-8209 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764511 | Titiana Shanee Richardson | Social Worker | 113 Lake Michigan Drive Northwest, Grand Rapids, MI 49544 | 2020-09-15 |
| 1699317792 | Leah Grace Nesburg | Speech-Language Pathologist | 600 3 Mile Road Nw, Suite 102, Walker, MI 49544 | 2019-10-10 |
| 1316467954 | Hendrik Vanholsbeeck | Dentist | 2515 Alpine Ave Nw # A, Grand Rapids, MI 49544 | 2017-06-25 |
| 1467988584 | Leah Feenstra | Behavior Technician | 668 3 Mile Nw, Grand Rapids, MI 49544 | 2017-05-10 |
| 1760920698 | Heidi Catherine Stultz-griffey | Pharmacist | 970 4 Mile Rd Nw Apt 1d, Grand Rapids, MI 49544 | 2017-02-12 |
| 1336591791 | Nicole Totten | Dentist | 3320 Alpine Ave., Grand Rapids, MI 49544 | 2016-07-11 |
| 1255789145 | Lucas David Kelley | Technician, Other | 668 3 Mile Ave Nw, Suite 2, Grand Rapids, MI 49544 | 2016-06-01 |
| 1144611666 | Stephen Kornoely | Social Worker | 2118 3 Mile Road Nw, Grand Rapids, MI 49544 | 2015-02-06 |
| 1023368305 | Brian William Rogers | Registered Nurse | 712 North Center Dr. Nw, Grand Rapids, MI 49544 | 2012-09-14 |
| 1477885325 | Wilson and Wynn Interventions | Community/Behavioral Health | 680 Three Mile Nw, Suite 150, Grand Rapids, MI 49544 | 2010-02-03 |
| Find all providers in zip 49544 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841609369 | Crystal Young | Clinical Neuropsychologist | 1550 E Beltline Ave Se, Suite 340, Grand Rapids, MI 49506-4301 | 2014-08-08 |
| 1861686784 | Lauren Elizabeth Spoon | Clinical Neuropsychologist | 3333 36th St Se, Grand Rapids, MI 49512-2809 | 2007-09-04 |
| 1538287495 | James Bernard De Boe | Clinical Neuropsychologist | 4131 Embassy Dr Se, Grand Rapids, MI 49546-2418 | 2007-03-27 |
| 1891867495 | Cherry Street Services, Inc. | Clinical Neuropsychologist | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2006-11-15 |
| 1477663599 | Don Allen Boyd | Clinical Neuropsychologist | 3300 Burton St Se Ste B, Grand Rapids, MI 49546-4398 | 2006-08-30 |
| 1598705675 | Thomas Charles Fuller | Clinical Neuropsychologist | 161 Ottawa Nw, Ste 300c, Grand Rapids, MI 49503-2707 | 2006-06-07 |
| 1447738877 | Draycen Decator | Clinical Neuropsychologist | 3292 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2018-07-28 |
| 1144717604 | Jaclyn Reckow | Clinical Neuropsychologist | 245 Cherry St Se Ste 104, Grand Rapids, MI 49503-4607 | 2018-04-19 |
| 1184172496 | Jesse J Piehl | Clinical Neuropsychologist | 3292 Evergreen Dr Ne, Grand Rapids, MI 49525-9580 | 2016-09-15 |
| 1144678020 | Alicia Beth Vanden Bussche Jantz | Clinical Neuropsychologist | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2016-06-01 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49544 |
Please comment or provide details below to improve the information on JON S BOS.
| 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.