NICOLE CAUGHERTY HAN
NPI 1801359872
Clinical Neuropsychologist in Grand Rapids, MI

Q: What is Nicole Caugherty Han's NPI number?

The NPI number for Nicole Caugherty Han is 1801359872. It was assigned to this individual provider in the NPPES registry on April 8, 2019.

Q: What is Nicole Caugherty Han's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Active since April 08, 2019PECOS Enrolled

3292 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525(616) 365-8920 Get Directions Write a Review

NPPES record last updated: September 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 11, 2022, Apr 8, 2019 (2 updates tracked since 2019).

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About Nicole Caugherty Han NPPES

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

NICOLE CAUGHERTY HAN (NPI 1801359872) is an individual clinical neuropsychologist in Grand Rapids, Michigan and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Phoenix, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1801359872

Entity TypeIndividualFemale

Primary Taxonomy103G00000X

Provider Legal NameNICOLE CAUGHERTY HAN

Location Address3292 N EVERGREEN DR NEGrand Rapids, MI 49525-9746

Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000

Phone(616) 365-8920

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateApril 8, 2019

Last NPPES UpdateSeptember 22, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 22, 2025

✔ NPI 1801359872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

Definition

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.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 6301019400 (MI)

3292 N EVERGREEN DR NE, Grand Rapids, MI 49525

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Secondary Practice Location 1

Location 11919 E Thomas RdPhoenix, AZ 85016-7710 · Phone (602) 933-1000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Caugherty Han is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6002305521

PECOS Enrollment IDI20251027000370

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.

Other Providers at the Same Location NPPES 20

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

NANCY HAMSTREET LMSW

Social Worker (School)