| Hra Psychological Services Pc | |
|
2851 Charlevoix Dr Se Ste 323 Grand Rapids MI 49546-7092 | |
| (616) 458-0692 | |
| (616) 458-8129 |
| Full Name | Hra Psychological Services Pc |
|---|---|
| Speciality | Social Worker |
| Location | 2851 Charlevoix Dr Se Ste 323, Grand Rapids, Michigan |
| Authorized Official Name and Position | Tracy Heckman (PRACTICE MANAGER) |
| Authorized Official Contact | 6164580692 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hra Psychological Services Pc 2851 Charlevoix Dr Se Ste 323 Grand Rapids MI 49546-7092 Ph: (616) 458-0692 | Hra Psychological Services Pc 2851 Charlevoix Dr Se Ste 323 Grand Rapids MI 49546-7092 Ph: (616) 458-0692 |
| NPI Number | 1003859984 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 08/14/2024 |
| Certification Date | 08/14/2024 |
| Medicare PECOS PAC ID | 8820994031 |
|---|---|
| Medicare Enrollment ID | O20031209000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003859984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Matthew M Ready |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528256286 PECOS PAC ID: 0840387536 Enrollment ID: I20071026000668 |
| Provider Name | Amy L Jarchow |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952480915 PECOS PAC ID: 6002914769 Enrollment ID: I20080430000813 |
| Provider Name | Robert J Baird |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932136165 PECOS PAC ID: 9638172364 Enrollment ID: I20080717000192 |
| Provider Name | Robert J Shaffer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720016959 PECOS PAC ID: 8820283906 Enrollment ID: I20101115000946 |
| Provider Name | Thomas C Fuller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598705675 PECOS PAC ID: 3870788961 Enrollment ID: I20101115001023 |
| Provider Name | Omar L Mangrum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457389157 PECOS PAC ID: 8820277130 Enrollment ID: I20110119000318 |
| Provider Name | Thomas M Spahn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467489914 PECOS PAC ID: 7618873829 Enrollment ID: I20110302000904 |
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