Kimberly Gerisse Vandale, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301014352 Issued in MI

Practice address

116 Market St
Perceptions Counseling Services
Mount Clemens, MI 48043-5674

Phone

(586) 465-4444

Fax

(586) 783-2761

NPI assigned

Feb 19, 2010

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Wayne State University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Perceptions Counseling Services, P.C.Group PAC ID 4183633753, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Perceptions Counseling Services, P.C.

  • Community/Behavioral Health Agency
  • Mount Clemens, MI
  • NPI 1043258734
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1053633974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MARKET ST",
            "address_2": "PERCEPTIONS COUNSELING SERVICES",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480435674",
            "telephone_number": "586-465-4444",
            "fax_number": "586-783-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MARKET ST",
            "address_2": "PERCEPTIONS COUNSELING SERVICES",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480435674",
            "telephone_number": "586-465-4444",
            "fax_number": "586-783-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDALE",
        "first_name": "KIMBERLY",
        "middle_name": "GERISSE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-19",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Herbert Unger, DDS
• Upward Transitions Counseling Inc.
• Stanley Joseph Urban III, PHARMD
• Karen L Valliere, R. N.
• Valor Health & Wellness
• Michael Vantiem, D.O.
• Heather Marie Vanvallis-Maczka, AGACNP-BC
• Anjali Makhijani Varma, D.O.
• Linda Vatnikaj, LLPC
• Tatianna Vega

• Psychologist in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.