DR. LEIGH PAVA WENDTLAND (PHD LLP) – Clinical Psychologist, NPI 1780663138
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,216 CLINICAL PSYCHOLOGIST in MI
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Provider Addresses for DR. LEIGH PAVA WENDTLAND (PHD LLP)
3330, Claystone Street Southeast, Third Ward, Grand Rapids, Kent County, Michigan, 49546, United States
GRAND RAPIDS, MI 495467716
Phone: (616) 942-8060
Fax: (616) 942-6690
Type: Location
PO BOX 30516
DEPT 6065
LANSING, MI 489098016
Phone: (616) 532-8000
Fax: (616) 532-7230
Type: Mailing
2401 CAMELOT CT SE STE E
GRAND RAPIDS, MI 495466083
Phone: (616) 648-2289
Fax: (616) 949-3018
Type: Mailing
2040 RAYBROOK AVE SE
SUITE 300
GRAND RAPIDS, MI 49546
Phone: (616) 949-7460
Fax: (616) 949-3018
Type: Mailing
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: 2011-08-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110819000038 | I | Clinical Psychologist | MI | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49546)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | MI | |
| Clinical Social Worker | MI | |
| Physician Assistant | MI | |
| Clinical Social Worker | MI | |
| Clinical Social Worker | MI | |
| - | MI | |
| Mental Health Counselor | MI | |
| Clinical Social Worker | MI |
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