POTENTIAL LLP PLLC
NPI 1992695563
Psychologist in Grand Rapids, MI

Active since July 07, 2025
5005 PLAINFIELD AVE NE STE 100, GRAND RAPIDS, MI 49525(616) 828-2788(616) 608-4657 Get Directions Write a Review

NPPES record last updated: July 7, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Potential Llp Pllc NPPES

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

POTENTIAL LLP PLLC (NPI 1992695563) is a healthcare organization registered as a psychologist in Grand Rapids, Michigan and active in the NPI registry since July 2025. The organization maintains a secondary practice location in Grand Rapids and lists Amanda Miller, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1992695563
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NamePOTENTIAL LLP PLLC
Location Address5005 PLAINFIELD AVE NE STE 100Grand Rapids, MI 49525-2087
Mailing Address144 Oakes St Sw Apt 1307Grand Rapids, MI 49503-3148 · (616) 828-2788 · Fax (616) 608-4657
Fax(616) 608-4657
Organization SubpartNo
Authorized OfficialAmanda MillerOwner/provider · (616) 828-2788
Enumeration DateJuly 7, 2025
NPPES CertifiedJuly 7, 2025
✔ NPI 1992695563 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.
5005 PLAINFIELD AVE NE STE 100, Grand Rapids, MI 49525

Secondary Practice Location 1

Location 1144 Oakes St SW Apt 1307Grand Rapids, MI 49503-3148 · Phone (616) 828-2788 · Fax (616) 608-4657

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted 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)

Potential Llp Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Potential LLP PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Psychologist Billing Independently
NPI 1407349269
3225 N EVERGREEN DR NE
Grand Rapids, MI 49525
(163) 641-5006
2.4 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 Potential LLP PLLC's NPI number?

The NPI number for Potential LLP PLLC is 1992695563. It was assigned to this organization in the NPPES registry on July 7, 2025.

Where is Potential LLP PLLC located?

Potential LLP PLLC is located at 5005 Plainfield Ave NE Ste 100, Grand Rapids, MI 49525. The listed phone number is (616) 828-2788.

What is Potential LLP PLLC's specialty?

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

Is Potential LLP PLLC enrolled in Medicare?

Yes. Potential LLP PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Potential LLP PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Psychologist Billing Independently) reassigns their Medicare billing to Potential LLP PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Potential LLP PLLC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Potential LLP PLLC 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 Potential LLP PLLC was last updated on July 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.