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

Individual provider Clinical Neuropsychologist · NPI 1063627396

Krestin Radonovich, PHD is a Clinical Psychologist in Grand Rapids, Michigan. Qualified in 1991, 35 years ago. Accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
35
Licensed in
MI
In the registry since
2007
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

3292 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone: (616) 365-8920
Fax: (616) 365-8971
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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 6301019674 (MI)
Clinical Neuropsychologist Taxonomy 103G00000X · Licence 6301019674 (MI)

Record details

NPI number1063627396
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedMay 11, 2007
Last updated in NPPESOctober 6, 2025
Certification dateOctober 6, 2025
Mailing address300 68th St Se, Grand Rapids, MI 49548-6927

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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