GREGORY SCOT DEACON (NPI# 1689740078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689740078 |
Entity Type | Individual |
Full Name | GREGORY SCOT DEACON |
Credential | LLP |
Practice Address |
201 Sheldon Blvd Se Grand Rapids MI 49503-4513 |
Practice Telephone | 6164594212 |
Practice Fax Number | 6167749022 |
Mailing Telephone | 6164594212 |
Mailing Fax Number | 6167749022 |
Enumeration Date | 2006-11-28 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
6301010405 | MI | Behavioral Health & Social Service Providers |
X | 103TC0700X |
Psychologist Specialization: Clinical |
6301010405 | MI | Behavioral Health & Social Service Providers |
X | 103TC1900X |
Psychologist Specialization: Counseling |
6301010405 | MI | Behavioral Health & Social Service Providers |
X | 104100000X | Social Worker | 6301010405 | MI | Behavioral Health & Social Service Providers |
X | 1041C0700X |
Social Worker Specialization: Clinical |
6301010405 | MI | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639365273 | Gregory S Deacon | Prosthetist | 315 Hospital Dr, Suite 104, Martinsville, VA 24112-1945 | 2007-09-18 |
Street Address |
201 SHELDON BLVD SE |
City | GRAND RAPIDS |
State | MI |
Zip Code | 49503-4513 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891888087 | Susan M Wolf | Social Worker | 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 | 2006-10-02 |
1821431453 | Latrece Mcdaniel | Social Worker | 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 | 2013-04-13 |
1780928945 | Christopher Robert Ostrander | Social Worker | 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 | 2012-11-11 |
1841559796 | Carmen Dieppa | Social Worker | 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 | 2012-05-14 |
1710245089 | Melissa Ann Grondsma | Social Worker | 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 | 2012-04-24 |
1912263245 | Amy Townley | Social Worker | 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 | 2012-04-11 |
1386910826 | Eugene Martin Koon | Social Worker | 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 | 2012-03-29 |
1215203856 | Travis Swieringa | Counselor | 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 | 2012-03-28 |
1548536154 | Allyson Tafelsky | Social Worker | 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 | 2012-03-28 |
1962772061 | Kurt David Keller | Social Worker | 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513 | 2012-01-05 |
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 | 103TB0200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Cognitive & Behavioral |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538531017 | Life Journey Pllc | Psychologist | 2013 East Castle Drive Sw, Suite B, Grand Rapids, MI 49508 | 2015-10-23 |
1164694006 | Andrea Lee Rotzien | Psychologist | 4701 Plainfield Ave. Ne, Suite C, Grand Rapids, MI 49525 | 2008-04-01 |
1427288000 | Carrie Louise Labarge | Psychologist | 680 3 Mile Rd Nw, Suite C, Grand Rapids, MI 49544-8218 | 2009-07-17 |
1770761850 | Judith Ellen Snow | Psychologist | 3501 Lake Eastbrook Blvd Se, Suite 146, Grand Rapids, MI 49546-5938 | 2008-01-31 |
1033398581 | Sandra Jean Wynn-stelt | Psychologist | 680 3 Mile Rd Nw, Suite C, Grand Rapids, MI 49544-8218 | 2007-11-01 |
1508057548 | Laura Lee Bennett | Psychologist | 1007 Parchment Dr Se, Grand Rapids, MI 49546-3664 | 2007-08-06 |
1073722542 | Mary Beth Child | Psychologist | 4701 Plainfield Ave Ne, Suite C, Grand Rapids, MI 49525-1644 | 2007-05-22 |
1649208018 | Victoria L Wilson | Psychologist | 680 3 Mile Rd Nw, Suite C, Grand Rapids, MI 49544-8218 | 2006-06-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144820598 | Alexander William Krieg | Psychologist | 31235 Ramble Rd, Franklin, MI 48025-1367 | 2020-10-26 |
1699389395 | Linda D Seltzer-sucher Phd LLC | Psychologist | 275 Bryn Mawr St, Birmingham, MI 48009-1501 | 2020-09-01 |
1780154435 | Erica Griffis Prime | Psychologist | 28066 Sunset Blvd W, Lathrup Village, MI 48076-2658 | 2018-11-26 |
1932600772 | Grand Blanc Psychology Pllc | Psychologist | 8382 Holly Rd Ste 1, Grand Blanc, MI 48439-1972 | 2018-02-27 |
1649792292 | Livingston Psychological Services, Pllc | Psychologist | 204 W Grand River Ave Ste 260, Howell, MI 48843 | 2017-07-14 |
1720529779 | Dannison | Psychologist | 604 S Rose St, Kalamazoo, MI 49007 | 2017-03-10 |
1912356254 | Maurice Moses Jr. | Psychologist | 541 Walbridge Dr, East Lansing, MI 48823-2039 | 2016-06-07 |
1548654148 | Darya Owens | Psychologist | 1235 Saint Clair St, Detroit, MI 48214-3671 | 2015-03-23 |
1538582671 | Laura Ann Wyglinski, Ph. D. | Psychologist | 4675 Okemos Rd, Okemos, MI 48864-1974 | 2014-01-25 |
1659669380 | Edward Dewitt Huntley Iv | Psychologist | 1681 Fulmer St, Ann Arbor, MI 48103-2452 | 2011-07-15 |
Find all providers with the same taxonomy |
City | GRAND RAPIDS |
Zip Code | 49503 |
Please comment or provide details below to improve the information on GREGORY SCOT DEACON.
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.