NPIMap

Organization Active NPI

Kalamazoo Psychology, LLC

  • Counseling Psychologist
  • Kalamazoo, MI
National Provider Identifier
1083879852
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
KALAMAZOO PSYCHOLOGY, LLC
Practice address
122 W South St
Kalamazoo, MI 49007-4711
Phone
(269) 349-4219
Fax
(269) 249-5107
NPI assigned
Jul 22, 2008
Last updated
Jul 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Mrs. Kimerly L. Lem, M.A., LLP
Title
Partner
Phone
(269) 349-4219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X MI Primary

Addresses

Primary practice location

122 W South St
Kalamazoo, MI 49007-4711

Mailing address

122 W South St
Kalamazoo, MI 49007-4711
Phone (269) 349-4219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040226000430 MI Part B Supplier - Clinic/Group Practice 5294621132 Receives reassigned benefits from 2 practitioners
Practice locations: Kalamazoo, MI

National Provider Directory

National Provider Directory
Tax ID family
Kalamazoo Psychology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1083879852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W SOUTH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074711",
            "telephone_number": "269-349-4219",
            "fax_number": "269-249-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W SOUTH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074711",
            "telephone_number": "269-349-4219",
            "fax_number": "269-249-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALAMAZOO PSYCHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "LEM",
        "authorized_official_first_name": "KIMERLY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "269-349-4219",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.A., LLP"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.