Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Rush Pediatric Neuropsychology, PLLC

Organization Clinical Neuropsychologist · NPI 1740997477

Rush Pediatric Neuropsychology, PLLC is a Clinical Neuropsychologist in Grand Rapids, Michigan. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

412 Plymouth Ave NE
Grand Rapids, MI 49505-6028
Phone: (616) 780-0590
Fax: (616) 984-4559
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X
Psychologist Taxonomy 103T00000X

Record details

NPI number1740997477
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shana Rush — Owner · (616) 780-0590
NPI enumeratedNovember 2, 2022
Last updated in NPPESMay 12, 2023
Certification dateMay 12, 2023
Mailing address412 Plymouth Ave Ne, Grand Rapids, MI 49505-6028

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