Kimberly Kay Wisdorf-Houtkooper, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301009191 Issued in MI

Practice address

71 S 20TH St Ste 209
Battle Creek, MI 49015-2900

Phone

(269) 501-0125

Fax

(888) 614-4010

NPI assigned

Sep 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Pediatric Psychological Services

  • Clinical Psychologist
  • Hastings, MI
  • NPI 1780733881
  NPD (past) Authorized official
• Pediatric Psychological Services PLLC

  • Clinical Psychologist
  • Battle Creek, MI
  • NPI 1952450108
  NPD (past) Authorized official
• Psychological Consultants of Michigan, P.C.

  • Psychologist
  • Battle Creek, MI
  • NPI 1407941677

  Clinical Child & Adolescent

  NPD (past)

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1073610796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5181 WALNUT RDG",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490179210",
            "telephone_number": "269-501-0125",
            "fax_number": "888-614-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 S 20TH ST STE 209",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490152900",
            "telephone_number": "269-501-0125",
            "fax_number": "888-614-4010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Meadow Run Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "MI",
            "postal_code": "490589054",
            "country_code": "US",
            "telephone_number": "269-501-0125",
            "fax_number": "888-614-4010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISDORF-HOUTKOOPER",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301009191",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301009191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Winnie, P.T.
• Ann Noel Winsor, M.A., LPC LLP
• Sabrina Ann Winters, LLPC
• Lisa Wireman, NP-C
• Kathleen M Wirtz, HEARING AID DEALER
• Tyler M Wise, PHARMD
• Caleena C Wiseman
• With You at Home LLC
• Valerie Elizabeth Withrow, FNP-C
• Michael Christopher Witt, LMSW

• Clinical Psychologist in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.