Kristen Louise Roy, MASTERS LTD PSYCHOL

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301010289 Issued in MI

Practice address

430 Bangor Road
Lawrence, MI 49064

Phone

(269) 674-4600

Fax

(269) 674-4126

NPI assigned

Sep 11, 2007

Last updated

Sep 11, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kristen Louise Hansen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1043405293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "address_2": "801 HAZEN STREET SUITE C",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490790249",
            "telephone_number": "269-657-5574",
            "fax_number": "269-657-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BANGOR ROAD",
            "city": "LAWRENCE",
            "state": "MI",
            "postal_code": "49064",
            "telephone_number": "269-674-4600",
            "fax_number": "269-674-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "KRISTEN",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "MASTERS LTD PSYCHOL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301010289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "HANSEN",
            "middle_name": "LOUISE",
            "prefix": "MISS",
            "credential": "MASTERS LTD PSYCHOL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychologist in Lawrence, MI
• Providers in Lawrence, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.