Individual provider Active NPI

Kaitlin Ann McCloskey, PHD

  • Clinical Neuropsychologist
  • Ann Arbor, MI
National Provider Identifier
1073965224
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6301018395 Issued in MI
Practice address
2101 Commonwealth Blvd
Ann Arbor, MI 48105-2969
Phone
(800) 525-5188
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X
Psychologist 103T00000X MI
Clinical Psychologist 103TC0700X 6301018395 MI
Clinical Neuropsychologist 103G00000X 6301018395 MI Primary

Addresses

Primary practice location

2101 Commonwealth Blvd
Ann Arbor, MI 48105-2969

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

79 W Alexandrine St
Detroit, MI 48201-2015
Phone (313) 831-5535

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200914000578 MI Practitioner - Clinical Psychologist 1658799390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

2101 Commonwealth Blvd
Ann Arbor, MI 48105-2969
Phone (734) 763-9259

700 Woodland Dr
Saline, MI 48176-1620
Phone (734) 429-2302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301018395MIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Michigan PastSince Apr 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1073965224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COMMONWEALTH BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052969",
            "telephone_number": "800-525-5188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79 W Alexandrine St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012015",
            "country_code": "US",
            "telephone_number": "313-831-5535",
            "fax_number": "313-831-2608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLOSKEY",
        "first_name": "KAITLIN",
        "middle_name": "ANN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018395",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301018395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.