Active NPI
Kathleen Wong Seitz, PHD
- Family Psychologist
- Traverse City, MI
National Provider Identifier
1053474031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Psychologist
- License
- 6301006659
- Practice address
- 921 West 11TH St
Ste 1E
Traverse City, MI 49684 - Phone
- (231) 946-6599
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Psychologist | 103TF0000X | 6301006659 | MI | Primary |
Addresses
Primary practice location
921 West 11TH St
Ste 1E
Traverse City, MI 49684
Mailing address
4342 Thoreson Rd
Maple City, MI 49664
Phone (231) 334-3677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301006659 | MI | MD | Family Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053474031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4342 THORESON RD",
"city": "MAPLE CITY",
"state": "MI",
"postal_code": "49664",
"telephone_number": "231-334-3677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "921 WEST 11TH ST",
"address_2": "STE 1E",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "49684",
"telephone_number": "231-946-6599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEITZ",
"first_name": "KATHLEEN",
"middle_name": "WONG",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "MI",
"license": "6301006659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.