DR. JOSHUA MATLACK


Address: 300 68th St Se, Grand Rapids, MI 49548-6927
Phone: 2546525335

DR. JOSHUA MATLACK (NPI# 1063067304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063067304
Entity Type Individual
Full Name DR. JOSHUA MATLACK
Credential PSYD
Practice Address 300 68th St Se
Grand Rapids
MI 49548-6927
Practice Telephone 2546525335
Enumeration Date 2019-08-05
Last Update Date 2020-11-05
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103T00000X Psychologist 6301017942 MI Behavioral Health & Social Service Providers
Y 103TC0700X Psychologist
Specialization: Clinical
6351004338 MI Behavioral Health & Social Service Providers

Office Location

Street Address 300 68TH ST SE
City GRAND RAPIDS
State MI
Zip Code 49548-6927

Providers in the same location

NPI Name Taxonomy Address Enumeration
1114920550 Emergency Physicians Inc PC General Practice 300 68th St Se, Grand Rapids, MI 49548-6927 2005-05-31
1235742768 Robert Milton Hughes Physician Assistant 300 68th St Se, Grand Rapids, MI 49548-6927 2020-08-25
1992317580 Jacob Alan Lowe Psychologist 300 68th St Se, Grand Rapids, MI 49548-6927 2020-08-17
1922619063 Jennifer Nicole Oconnor Social Worker 300 68th St Se, Grand Rapids, MI 49548-6927 2020-08-12
1407464670 Christina Joy Weaver Physician Assistant 300 68th St Se, Grand Rapids, MI 49548-6927 2020-07-14
1780200436 Wendy Forrest Psychiatry & Neurology 300 68th St Se, Grand Rapids, MI 49548-6927 2020-06-18
1003430877 Cory Manoogian Psychiatry & Neurology 300 68th St Se, Grand Rapids, MI 49548-6927 2020-06-08
1992329650 Amy Joy Smith Psychologist 300 68th St Se, Grand Rapids, MI 49548-6927 2020-05-29
1134743800 Brendan Mcneilly Psychiatry & Neurology 300 68th St Se, Grand Rapids, MI 49548-6927 2020-05-29
1467075176 Luke Vander Wal Psychologist 300 68th St Se, Grand Rapids, MI 49548-6927 2020-05-28
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205319811 Pooja Patel Social Worker Spectrum Community Services, 3353 Lousma Dr. Se, Wyoming, MI 49548 2018-09-10
1063906865 Kimberly Eccher Physician Assistant 300 68th St. Se, Grand Rapids, MI 49548 2018-06-15
1871099481 Baymark of Michigan, Inc. Clinic/Center 5500 Division Avenue Se, Kentwood, MI 49548 2018-04-03
1629507801 Laura Marie Quennoz Psychiatry & Neurology Pine Rest Christian Mental Health Services, 300 68th Street Se, Grand Rapids, MI 49548 2017-06-09
1821548504 Alison Anderson Technician, Other 103 Roth St Se, Grand Rapids, MI 49548 2016-10-06
1831540152 Jesse Aubil Counselor 264 Montebello St. Se 49548, Grand Rapids, MI 49548 2016-06-28
1306237920 Sarah Benton Social Worker 225 Colrain St Sw, 2, Grand Rapids, MI 49548 2015-02-18
1578996856 Karen Marie Irving Social Worker 3353 Lousma Dr. Se, Wyoming, MI 49548 2013-08-09
1740348044 Robert Kenneth Richmond Preventive Medicine 551 36th Street. Se, Wyoming, MI 49548 2006-12-05
1386738953 Sharita Montiez Hall Social Worker 300 68th Street Se, Grand Rapids, MI 49548 2006-10-03
Find all providers in zip 49548

Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1427553007 Rachel E Keelan Psychologist 350 Lafayette Ave Se Fl 5, Grand Rapids, MI 49503-4656 2018-03-27
1235504655 Olivia Torres Sprauer Psychologist 833 Kenmoor Ave Se Ste A, Grand Rapids, MI 49546-2390 2015-12-10
1366835589 Dr Marcia Hollingsworth, Ed.d, Pllc Psychologist 2025 E Beltline Ave Se Ste 102, Grand Rapids, MI 49546-7673 2015-03-12
1881945855 John Shepherd Carton Psychologist 265 Wealthy St Se, Grand Rapids, MI 49503 2012-10-01
1386995900 Jane L. Spies-wert, Ph.d., P.C. Psychologist 15 Ionia Ave Sw, Suite 645, Grand Rapids, MI 49503-4102 2012-09-21
1144577396 Amy Kristine Byerley Psychologist 668 3 Mile Rd Nw Ste D, Grand Rapids, MI 49544-8219 2012-08-07
1326271750 Jonathan Jay Eggerichs Psychologist 770 Kenmoor Ave Se Ste 101, Grand Rapids, MI 49546-8621 2009-09-02
1669604658 Lyndsay Kate Volpe-bertram Psychologist 1179 East Paris Ave Se, Grand Rapids, MI 49546-8371 2009-08-10
1568609659 Dr. Steven A. Harris, P.C. Psychologist 2618 East Paris, S.e. Suite B, Grand Rapids, MI 49546 2009-01-12
1255586228 Dominic Amante Psychologist 29 Pearl N.w., 114 Federal Square Bldg., Grand Rapids, MI 49503 2008-11-18
Find all providers in GRAND RAPIDS

Competitor

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City GRAND RAPIDS
Zip Code 49548

Improve Information

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Dataset Information

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.

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