GREGORY SCOT DEACON


Address: 201 Sheldon Blvd Se, Grand Rapids, MI 49503-4513
Phone: 6164594212

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).

Provider Overview

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

Taxonomy

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

Other Providers GREGORY DEACON

NPI Name Taxonomy Address Enumeration
1639365273 Gregory S Deacon Prosthetist 315 Hospital Dr, Suite 104, Martinsville, VA 24112-1945 2007-09-18

Office Location

Street Address 201 SHELDON BLVD SE
City GRAND RAPIDS
State MI
Zip Code 49503-4513

Providers in the same location

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
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Taxonomy Information

Taxonomy Code 103TB0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Cognitive & Behavioral

Taxonomy Definition

Definition to come...
Notes: [1/1/2007: title modified]

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1427288000 Carrie Louise Labarge Psychologist 680 3 Mile Rd Nw, Suite C, Grand Rapids, MI 49544-8218 2009-07-17
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1649208018 Victoria L Wilson Psychologist 680 3 Mile Rd Nw, Suite C, Grand Rapids, MI 49544-8218 2006-06-28

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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
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1548654148 Darya Owens Psychologist 1235 Saint Clair St, Detroit, MI 48214-3671 2015-03-23
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Competitor

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City GRAND RAPIDS
Zip Code 49503

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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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