Active NPI
Austin Henry Kovar, MA, TLLP
- Psychologist
- Wayne, MI
National Provider Identifier
1114304615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301016418
- Practice address
- 35640 W Michigan Ave
Wayne, MI 48184-1628 - Phone
- (734) 729-7792
- NPI assigned
- May 4, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301016418 | MI | Primary |
Addresses
Primary practice location
35640 W Michigan Ave
Wayne, MI 48184-1628
Mailing address
25857 Springbrook Dr
Farmington Hills, MI 48336-1377
Phone (248) 320-6750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301016418 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Medical Center of Michigan, Inc | Past | Accepting new patients |
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.
-
- Federally Qualified Health Center (FQHC)
- Adrian, MI
- NPI 1457640930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439424000000",
"number": "1114304615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25857 SPRINGBROOK DR",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483361377",
"telephone_number": "248-320-6750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35640 W MICHIGAN AVE",
"city": "WAYNE",
"state": "MI",
"postal_code": "481841628",
"telephone_number": "734-729-7792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOVAR",
"first_name": "AUSTIN",
"middle_name": "HENRY",
"name_prefix": "Mr.",
"credential": "MA, TLLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-04",
"last_updated": "2015-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301016418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.