JUSTIN SIDES PSYD
NPI 1104276690
Psychologist in West Olive, MI

Active since June 15, 2016PECOS Enrolled
9272 SHOREWAY DR, WEST OLIVE, MI 49460(616) 886-9001 Get Directions Write a Review

NPPES record last updated: March 29, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 29, 2025, Oct 1, 2018, Sep 18, 2017 and 1 more (4 updates tracked since 2016).

About Justin Sides Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN SIDES PSYD (NPI 1104276690) is an individual psychologist in West Olive, Michigan, licensed in Michigan (6301017242) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104276690
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameJUSTIN SIDESCredential: PSYD
Location Address9272 SHOREWAY DRWest Olive, MI 49460-8866
Mailing Address9272 Shoreway DrWest Olive, MI 49460-8866 · (616) 886-9001
Sole ProprietorNo
Enumeration DateJune 15, 2016
Last NPPES UpdateMarch 29, 20254 updates tracked since enumeration
NPPES CertifiedMarch 29, 2025
✔ NPI 1104276690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MI · 6301017242
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
9272 SHOREWAY DR, West Olive, MI 49460

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Sides Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Justin Sides reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Clinical
340 104TH AVE
Holland, MI 49423
  • Reassigned Medicare billing, Michigan enrollment
  • 32 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
9272 SHOREWAY DR
WEST OLIVE, MI 49460

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Sides's NPI number?

The NPI number for Justin Sides is 1104276690. It was assigned to this individual provider in the NPPES registry on June 15, 2016.

Where is Justin Sides located?

Justin Sides practices at 9272 Shoreway Dr, West Olive, MI 49460. The listed phone number is (616) 886-9001.

What is Justin Sides's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Justin Sides enrolled in Medicare?

Yes. Justin Sides is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Justin Sides's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justin Sides reassigns Medicare benefits to Hope & Wholeness Psychology Center, LLC (Holland, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Justin Sides's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Justin Sides accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Justin Sides as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Justin Sides was last updated on March 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.