CHARLES E. GRAYSON PH.D.
NPI 1942405303
Psychologist in Grand Rapids, MI

Active since June 17, 2007Opted out of Medicare · through Jan 7, 2027
2894 THORNAPPLE RIVER DR SE, GRAND RAPIDS, MI 49546(616) 285-6080 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Charles E. Grayson Ph.d. NPPES

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

CHARLES E. GRAYSON PH.D. (NPI 1942405303) is an individual psychologist in Grand Rapids, Michigan and active in the NPI registry since June 2007. He has opted out of Medicare through January 7, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1942405303
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameCHARLES E. GRAYSONCredential: PH.D.
Location Address2894 THORNAPPLE RIVER DR SEGrand Rapids, MI 49546-6857
Mailing Address2894 Thornapple River Dr SeGrand Rapids, MI 49546-6857 · (616) 285-6080
Sole ProprietorYes
Enumeration DateJune 17, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1942405303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
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.

2894 THORNAPPLE RIVER DR SE, Grand Rapids, MI 49546

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Charles E. Grayson Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 7, 2013 through January 7, 2027.

Opt-Out Effective DateJanuary 7, 2013
Opt-Out In Effect ThroughJanuary 7, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 4

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

Psychiatry & Neurology (Psychiatry)
2894 THORNAPPLE RIVER DR SE
GRAND RAPIDS, MI 49546
Psychologist (Counseling)
2894 THORNAPPLE RIVER DR SE
GRAND RAPIDS, MI 49546
Psychologist (Clinical)
2894 THORNAPPLE RIVER DR SE
GRAND RAPIDS, MI 49546
Psychologist (Clinical)
2894 THORNAPPLE RIVER DR SE
GRAND RAPIDS, MI 49546

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1942405303, enumerated as an "individual" on June 17, 2007.

The provider is located at 2894 THORNAPPLE RIVER DR SE GRAND RAPIDS, MI 49546 and the phone number is (616) 285-6080.

Psychologist with taxonomy code 103T00000X.