Jacquelyn Kellogg, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

JACQUELYN KELLOGG, LLC

Practice address

6018 Cornerstone CT SW
Grandville, MI 49418

Phone

(616) 340-1061

NPI assigned

Feb 6, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacquelyn Kay Kellogg, MA, LLP

Title

Psychologist

Phone

(616) 340-1061

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1023714409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6018 CORNERSTONE CT SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "49418",
            "telephone_number": "616-340-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6018 CORNERSTONE CT SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "49418",
            "telephone_number": "616-340-1061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4950 32nd Ave",
            "address_purpose": "LOCATION",
            "city": "Hudsonville",
            "state": "MI",
            "postal_code": "494261729",
            "country_code": "US",
            "telephone_number": "616-340-1061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACQUELYN KELLOGG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "KELLOGG",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "616-340-1061",
        "authorized_official_credential": "MA, LLP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth B Irving, PHARM D
• Said O Ismail, MD
• Ivanrest Family Dentistry
• Jack a Dekkinga MD PC
• Jennifer Jacobusse
• James a. Kessel, DDS, PC
• James M Pouillon DPM PLC
• Diane Shahara Jamoua, O.D.
• Jane J Jawahir MD PC
• Hailee Madisen Jarchow, BEHAVIOR TECHNICIAN

• Clinical Psychologist in Grandville, MI
• Providers in Grandville, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.