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THE SHORELINE CENTER LLC
NPI 1942689708
Psychologist - Clinical in Grand Haven, MI

Active since May 27, 2015
16925 ABILITY WAY, GRAND HAVEN, MI 49417(616) 935-7606(616) 935-7607 Get Directions Write a Review

NPPES record last updated: August 3, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About The Shoreline Center Llc NPPES

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

THE SHORELINE CENTER LLC (NPI 1942689708) is a healthcare organization registered as a clinical in Grand Haven, Michigan and active in the NPI registry since May 2015. The organization maintains a secondary practice location in Grand Haven and lists Dan Radley, Owner, as its authorized official.

NPPES Registry Identity

NPI1942689708
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameTHE SHORELINE CENTER LLC
Location Address16925 ABILITY WAYGrand Haven, MI 49417-9325
Mailing Address16925 Ability WayGrand Haven, MI 49417-9325 · (616) 935-7606
Phone(616) 935-7606
Fax(616) 935-7607
Organization SubpartNo
Authorized OfficialDan RadleyOwner · (616) 935-7606
Enumeration DateMay 27, 2015
Last NPPES UpdateAugust 3, 2021
NPPES CertifiedAugust 3, 2021
✔ NPI 1942689708 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 · 6301014390
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 ListedClinic/Center · Developmental DisabilitiesTaxonomy 261QD1600X
16925 ABILITY WAY, Grand Haven, MI 49417
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Secondary Practice Location 1

Location 116930 Robbins Rd, Suite 120Grand Haven, MI 49417-2787 · Phone (616) 935-0747

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, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

The Shoreline Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to The Shoreline Center LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Tatum Johnson
Occupational Therapist in Private Practice
NPI 1124971437
16925 ABILITY WAY
Grand Haven, MI 49417
(616) 935-7606
2.3 mi
Rebecca Clawson
Qualified Speech Language Pathologist
NPI 1104398981
1409 W CARROLL AVE
Chicago, IL 60607
(312) 733-0883
110 mi

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

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 The Shoreline Center LLC's NPI number?

The NPI number for The Shoreline Center LLC is 1942689708. It was assigned to this organization in the NPPES registry on May 27, 2015.

Where is The Shoreline Center LLC located?

The Shoreline Center LLC is located at 16925 Ability Way, Grand Haven, MI 49417. The listed phone number is (616) 935-7606.

What is The Shoreline Center LLC's specialty?

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

Is The Shoreline Center LLC enrolled in Medicare?

Yes. The Shoreline Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through The Shoreline Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to The Shoreline Center LLC, in Occupational Therapist in Private Practice and Qualified Speech Language Pathologist. A 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 the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does The Shoreline Center LLC accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list The Shoreline Center LLC 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 The Shoreline Center LLC was last updated on August 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.