WESTSIDE NEUROPSYCHOLOGY PLLC NPI 1417848763

NPI Information

  • NPI: 1417848763
  • Provider Name: WESTSIDE NEUROPSYCHOLOGY, PLLC
  • Classification: Clinical Neuropsychologist - 103G00000X
  • Entity Type: Organization
  • Address: 5030 CORPORATE EXCHANGE BLVD SE STE 201
    GRAND RAPIDS, MI
    ZIP 49512
  • Phone: (616) 287-4164

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NPI Details

WESTSIDE NEUROPSYCHOLOGY, PLLC is a clinical neuropsychologist in Grand Rapids, MI. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. WESTSIDE NEUROPSYCHOLOGY, PLLC NPI is 1417848763. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5030 CORPORATE EXCHANGE BLVD SE STE 201
GRAND RAPIDS, MI
ZIP 49512-506
Phone: (616) 287-4164

The provider's authorized official is Velisa Johnson .
The authorized official title is Clinical Neuropsychologist/owner and has the following contact phone number (616) 287-4164.

The enumeration date for this NPI number is 7/14/2025 and was last updated on 7/14/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103G00000XClinical NeuropsychologistYes

What is NPI?

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This page was last updated on: 3/30/2025

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