GRAND LEDGE COUNSELING CENTER PC — NPI 1083714760 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1083714760

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

103T00000X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist

Box 32 Service Location & ZIP+4

6526 DEEPWATER POINT RD, WILLIAMSBURG, MI, 49690-9246

✓ 9-Digit EDI 837 ZIP+4 (49690-9246)

Practice Phone & Referral Fax

(517) 627-8357

Fax: (517) 627-8972

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1083714760 (GRAND LEDGE COUNSELING CENTER PC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1083714760` (NPI-2 Organization / Facility)
Provider / Legal Name	GRAND LEDGE COUNSELING CENTER PC
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist NUCC Code: `103T00000X` (Psychologist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	6526 DEEPWATER POINT RD, WILLIAMSBURG, MI, 49690-9246
Practice Telephone / Fax	Tel: (517) 627-8357 \| Fax: (517) 627-8972
Administrative Mailing Address	PO BOX 10, MASON, MI, 48854-0010
Enumeration & Last Sync	Enumerated: 2006-09-23 \| CMS Record Updated: 2024-05-21
Authorized Official	ARTHUR MYERS (President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

6526 DEEPWATER POINT RD, WILLIAMSBURG, MI, 49690-9246

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Plain-English Taxonomy & CMS Crosswalk (103T00000X)

What Does Taxonomy Code 103T00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103T00000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (GRAND LEDGE COUNSELING CENTER PC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: MI \| License: `Verified` \| Primary: Yes (Primary)
`104100000X` — Social Worker Plain English: Licensed & Credentialed Social Worker	State: MI \| License: `Verified` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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GRAND LEDGE COUNSELING CENTER PC (NPI #1083714760)