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NPI Code Detail

MEDICARE: PSYCHOLOGICAL INSIGHTS, LLC

MEDICARE: PSYCHOLOGICAL INSIGHTS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1053172239
Entity Type Code : Organization
Provider Name (Legal Business Name) : PSYCHOLOGICAL INSIGHTS, LLC
Provider Business Mailing Address
First Line : 265 KOLLEN PARK DR
Second Line :
City : HOLLAND
State : MI
Zip : 49423-3401
Country : US
Telephone Number : 616-681-3955
Fax Number : 616-681-3958
Provider Business Practice Location Address
First Line : 265 KOLLEN PARK DR
Second Line :
City : HOLLAND
State : MI
Zip : 49423-3401
Country : US
Telephone Number : 616-681-3955
Fax Number : 616-681-3958
Authorized Official
Title or Position : OWNER
Name : DR. REBECCA LYNN GOMEZ DE TUINSTRA
Credential : PH.D., DLLP
Telephone Number : 616-681-3955
Provider Enumeration Date : 01/16/2024
Last Update Date : 01/08/2025

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