Great Lakes Psychological Associates PLLC
NPI 1205205747 · Clinical Psychologist · Mt Pleasant, MI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Great Lakes Psychological Associates PLLC is a Clinical Psychologist organization in Mt Pleasant, MI (NPI 1205205747).
Provider details
- NPI number
- 1205205747
- Entity type
- Organization
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Jeremy Moeggenberg, Owner(989) 317-3188
- License
- 6301014926 (MI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2015-09-15
- Last updated
- 2019-01-04
Frequently asked questions
- What is Great Lakes Psychological Associates PLLC's NPI number?
- Great Lakes Psychological Associates PLLC's National Provider Identifier (NPI) is 1205205747, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Great Lakes Psychological Associates PLLC?
- Great Lakes Psychological Associates PLLC is classified in the NPPES registry as Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Great Lakes Psychological Associates PLLC located?
- Great Lakes Psychological Associates PLLC's practice location on file with NPPES is 400 S University Ave, Mt Pleasant, MI 48858-3170.
- What is Great Lakes Psychological Associates PLLC's phone number?
- The practice phone number listed in the NPPES registry for Great Lakes Psychological Associates PLLC is (989) 317-3188.
- Does Great Lakes Psychological Associates PLLC accept Medicare?
- Great Lakes Psychological Associates PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Great Lakes Psychological Associates PLLC?
- The authorized official listed on Great Lakes Psychological Associates PLLC's NPPES record is Jeremy Moeggenberg, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Great Lakes Psychological Associates PLLC's NPI active?
- Yes — Great Lakes Psychological Associates PLLC's NPI (1205205747) is active in the NPPES registry as of the last update on 2019-01-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.