Kathleen Jandernoa Cramer, PHD, L.P.
Individual provider Active NPI Clinical Psychologist · Ada, MI
NPI 1083765812 · NPPES record last updated Jun 13, 2025
Key facts
- NPI
- 1083765812
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 6301013342 (MI)
- Practice address
- 967 Spaulding Ave SE
Ada, MI 49301-3700 - Phone
- (616) 464-3424
- Fax
- (616) 949-5336
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
967 Spaulding Ave SE
Ada, MI 49301-3703
Phone (616) 464-3424
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160208000054 | MI | Practitioner - Clinical Psychologist | 5496059081 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301013342 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kjc323Pllc | Clinical | Current |
Accepting new patients |
Locations
967 Spaulding Ave SE
Ada, MI 49301
Phone (616) 464-3424
967 Spaulding Ave SE
Ste E
Ada, MI 49301
Phone (616) 581-3085
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301013342 | MI | Yes |
Addresses
Primary practice location
967 Spaulding Ave SE
Ada, MI 49301-3700
Mailing address
4205 Baywood Dr SE
Grand Rapids, MI 49546-2288
Phone (616) 957-7807
Other providers in Ada, MI
- Concierge Medicine of Grand Rapids
- Connection Counseling LLC
- Cheryl Lynn Cooper
- Emily Cordes
- Cornerstone Caregiving East LLC
- Ethan Brent Cunningham
- Conor Dahlquist
- Daniel K. Ehnis, PC
- Kristen Daniels
- Stacy L Davis
All providers in Ada, MI · Clinical Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.