DR. BETH JOY BLACKBIRD (PSYD) – Rehabilitation Psychologist, NPI 1689631251

DR. BETH JOY BLACKBIRD (PSYD) is a healthcare provider. based in Grand rapids, Michigan. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. 6301010300 (MI). The NPI Number for DR. BETH JOY BLACKBIRD (PSYD) is 1689631251

Main info

Female
35 Years Of Experience
Accepts Medicare Assignment
Name
DR. BETH JOY BLACKBIRD (PSYD)
NPI
1689631251
Phone
(616) 840-8668
Address
235 WEALTHY ST SE
Enumeration Date
27 April 2006
Last Update Date
8 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6162420422
Graduation Year
1991 (35 years ago)
PAC ID
2365590502
Group Practice PAC ID
4587576541
Professional Enrollment ID
I20090428000394
Address ID
MI495035247GR235XXSEXX400

Contacts

Secure Messaging
eblackbird90185@direct.covenanthealthcare.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

1,216 CLINICAL PSYCHOLOGIST in MI

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Provider Addresses for DR. BETH JOY BLACKBIRD (PSYD)

  • Mary Free Bed Rehabilitation Center, 235, Wealthy Street Southeast, Third Ward, Grand Rapids, Kent County, Michigan, 49503, United States

    GRAND RAPIDS, MI 495035247

    Phone: (616) 840-8668

    Fax: (616) 840-9762

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-04-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090428000394IClinical PsychologistMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90832Psychotherapy, 30 minutes186105$0
90791Psychiatric diagnostic evaluation175173$0
View full utilization report →

Insurance plans in this area (ZIP 49503)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587576541View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeOK
Physical Medicine And RehabilitationMI
Physical Medicine And RehabilitationMI
Physical Therapist In Private PracticeMI
Physical Medicine And RehabilitationMI
-MI
Physical Medicine And RehabilitationMI
Physical Therapist In Private PracticeMI
-MI

Reviews

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Frequently asked questions

Is DR. BETH JOY BLACKBIRD (PSYD) listed with a National Provider Identifier?
Yes — DR. BETH JOY BLACKBIRD (PSYD) has NPI 1689631251 on file in the registry.
Is DR. BETH JOY BLACKBIRD (PSYD) shown as active in public data?
Registry records indicate DR. BETH JOY BLACKBIRD (PSYD) maintains an active NPI.
What clinical focus is listed for DR. BETH JOY BLACKBIRD (PSYD)?
At a glance, DR. BETH JOY BLACKBIRD (PSYD) is tied to Rehabilitation Psychologist. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. BETH JOY BLACKBIRD (PSYD)?
Directory geography for DR. BETH JOY BLACKBIRD (PSYD) centers on Grand Rapids, Michigan.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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