Individual provider Active NPI

Betz King, PSY. D

  • Clinical Psychologist
  • Farmington Hills, MI
National Provider Identifier
1083833594
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301013348 Issued in MI
Practice address
26105 Orchard Lake Rd
Suite 207
Farmington Hills, MI 48334-4576
Phone
(248) 788-5798
Fax
(248) 957-8544
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301013348 MI Primary

Addresses

Primary practice location

26105 Orchard Lake Rd
Suite 207
Farmington Hills, MI 48334-4576

Mailing address

26105 Orchard Lake Rd
Suite 207
Farmington Hills, MI 48334-4576
Phone (248) 788-5798

Other identifiers 1

IdentifierTypeStateIssuer
11627369OtherMICAQH

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
I20090721000502 MI Practitioner - Clinical Psychologist 0143372227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Betz King PCGroup PAC ID 7315099405, 2 clinicians

Practice addresses (Care Compare)

32770 Grand River Ave
Farmington Hills, MI 48336-3159
Phone (313) 338-8130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301013348MIMDClinical Psychologist

Organizations & group practices 1

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1083833594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26105 ORCHARD LAKE RD",
            "address_2": "SUITE 207",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344576",
            "telephone_number": "248-788-5798",
            "fax_number": "248-957-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26105 ORCHARD LAKE RD",
            "address_2": "SUITE 207",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344576",
            "telephone_number": "248-788-5798",
            "fax_number": "248-957-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "BETZ",
        "name_prefix": "Dr.",
        "credential": "PSY. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11627369",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.