Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Randall Lee Herrema, PSYD

Individual provider Clinical Psychologist · NPI 1063569150

Dr. Randall Lee Herrema, PSYD is a Clinical Psychologist in Grand Rapids, Michigan. Qualified in 1986, 40 years ago. Practices with Centennial Park Counseling PLLC, an 8-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
40
Licensed in
MI
In the registry since
2007
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

3501 Lake Eastbrook Blvd SE Ste 280
Grand Rapids, MI 49546-5938
Phone: (616) 942-7331
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 6301003721 (MI)

Record details

NPI number1063569150
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorYes
NPI enumeratedJanuary 4, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1986 (40 years in practice)
Group practice Centennial Park Counseling Pllc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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