DR. MIRA CHARLOTTE JOURDAN PHD
NPI 1902194806
Psychologist - Clinical in Kentwood, MI

Q: What is Mira Jourdan's NPI number?

The NPI number for Mira Jourdan is 1902194806. It was assigned to this individual provider in the NPPES registry on July 13, 2011. The provider is also known as Mira Charlotte Krishnan Phd.

Q: What is Mira Jourdan's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Mira Jourdan was last updated on August 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.

Active since July 13, 2011PECOS Enrolled

3361 36TH ST SE, KENTWOOD, MI 49512(616) 942-2522(616) 956-3260 Get Directions Write a Review

NPPES record last updated: August 25, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 25, 2021, Aug 4, 2021, Mar 16, 2016 (3 updates tracked since 2016).

On this page

About Dr. Mira Charlotte Jourdan Phd NPPES

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

DR. MIRA CHARLOTTE JOURDAN PHD (NPI 1902194806) is an individual clinical provider in Kentwood, Michigan, licensed in Michigan (6301014267) and active in the NPI registry since July 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902194806

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. MIRA CHARLOTTE JOURDANCredential: PHD

Location Address3361 36TH ST SEKentwood, MI 49512-2809

Mailing Address2626 Brooklyn Ave SeGrand Rapids, MI 49507-3937 · (248) 885-4992 · Fax (616) 825-6264

Phone(616) 942-2522

Fax(616) 956-3260

Sole ProprietorYes

Enumeration DateJuly 13, 2011

Last NPPES UpdateAugust 25, 20213 updates tracked since enumeration

NPPES CertifiedAugust 25, 2021

✔ NPI 1902194806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MI · 6301014267

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedClinical NeuropsychologistTaxonomy 103G00000X · License 6301014267 (MI)

3361 36TH ST SE, Kentwood, MI 49512

Open in Google Maps ↗

Other Names 1

Former Name (1)Mira Charlotte Krishnan Phd

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include McLaren Health Plan Community, Priority Health.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)

Dr. Mira Charlotte Jourdan Phd 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49512 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$166.68 typical visit price

range $54.34 – $166.68

Typical copayment $41.67 (range $13.58 – $41.67)

Most-billed visit code 99205

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

FELICIA ROSE BROSS M.A., CCC-SLP

Speech-Language Pathologist

3361 36TH ST SE
GRAND RAPIDS, MI 49512

Kent County (616) 942-2522

ALEXANDRA LEIGH TERPSTRA

Behavior Analyst