LIDDERDALE CONSULTING PLC (NPI# 1568080687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568080687 |
| Entity Type | Organization |
| Organization Name | LIDDERDALE CONSULTING PLC |
| Other Organization Name | MELISSA A. LIDDERDALE PLC |
| Practice Address |
1000 Monroe Ave Nw Grand Rapids MI 49503-1455 |
| Mailing Address |
57 Courtland St Unit 794 Rockford MI 49341-5027 |
| Practice Telephone | 6164269193 |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | MELISSA ANN LIDDERDALE (PSYCHOLOGIST/OWNER) |
| Authorized Official Telephone | 6164269193 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Melissa A. Lidderdale PLC | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 668 3 Mile Rd Nw Ste D, Grand Rapids, MI 495448219 | 6164269193 | 6164269455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871613968 | Lidderdale Consulting Plc | Psychologist | 1000 Monroe Ave Nw, Grand Rapids, MI 49503-1455 | 2007-03-30 |
| Street Address |
1000 MONROE AVE NW |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-1455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053399659 | Timothy James Fife | Anesthesiology | 1000 Monroe Ave Nw, Grand Rapids, MI 49503-1455 | 2006-01-04 |
| 1821603283 | Micah John White | Psychologist | 1000 Monroe Ave Nw, Grand Rapids, MI 49503-1455 | 2020-09-12 |
| 1194365155 | James Joseph Rossi | Psychologist | 1000 Monroe Ave Nw, Grand Rapids, MI 49503-1455 | 2020-01-08 |
| 1346721438 | Kerry Nicole Beduna | Psychologist | 1000 Monroe Ave Nw, Grand Rapids, MI 49503-1455 | 2018-08-27 |
| 1245756097 | Loanna Abreu Perez | Psychologist | 1000 Monroe Ave Nw, Grand Rapids, MI 49503-1455 | 2017-08-14 |
| 1487178554 | Raymond Leoine Sheets Jr. | Psychologist | 1000 Monroe Ave Nw, Grand Rapids, MI 49503-1455 | 2017-08-01 |
| 1396116125 | Amy Lynn Ver Wey | Psychologist | 1000 Monroe Ave Nw, Grand Rapids, MI 49503-1455 | 2015-10-20 |
| 1356725238 | Laura Hazekamp | Counselor | 1000 Monroe Ave Nw, Grand Rapids, MI 49503-1455 | 2015-07-10 |
| 1518353630 | Stephen E. Craig | Counselor | 1000 Monroe Ave Nw, Grand Rapids, MI 49503 | 2015-04-15 |
| 1073926457 | Nicole Marganti | Psychologist | 1000 Monroe Ave Nw, Grand Rapids, MI 49503-1455 | 2014-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| 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 |
|---|---|---|---|---|
| 1205490240 | Maxwell Taylor | Psychologist | 401 Hall St Sw Ste 112b, Grand Rapids, MI 49503-4988 | 2019-04-25 |
| 1760995146 | Stephanie Elizabeth Karek | Psychologist | 4467 Cascade Rd Se Ste A4469, Grand Rapids, MI 49546-3791 | 2017-11-08 |
| 1114447745 | Andrea Gumbko | Psychologist | 3403 Michigan St Ne, Grand Rapids, MI 49525-3408 | 2017-06-24 |
| 1720529332 | Clearwater Counseling & Wellness LLC | Psychologist | 1525 E Beltline Se, Grand Rapids, MI 49525-4598 | 2017-03-15 |
| 1851748768 | Heather Dermyer, LLC | Psychologist | 3330 Centennial Rdg, #205, Grand Rapids, MI 49546-7098 | 2016-05-20 |
| 1902265234 | Lauren Conkright | Psychologist | 1009 44th St Se, Suite 103, Grand Rapids, MI 49508 | 2016-02-15 |
| 1225409220 | Christian Robert Komor | Psychologist | 235 Louis St Nw, Grand Rapids, MI 49503-2600 | 2015-10-15 |
| 1780022194 | Gregory V Mallis | Psychologist | 1870 Leonard St Se, Grand Rapids, MI 49505-5650 | 2013-06-07 |
| 1821344136 | Laura Ann Doughty | Psychologist | 800 Monroe Ave Nw Ste 206, Grand Rapids, MI 49503-1448 | 2012-07-24 |
| 1528321296 | Mikhila N Wildey | Psychologist | 300 58th St Se, Grand Rapids, MI 49548-5984 | 2012-06-19 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
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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.