Active NPI
Calder W Kaufman, PSYD
- Clinical Psychologist
- Troy, MI
National Provider Identifier
1124337985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301016538
- Practice address
- 2075 W Big Beaver Rd
Suite 520
Troy, MI 48084-3407 - Phone
- (248) 646-6659
- NPI assigned
- Sep 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301016538 | MI | Primary |
Addresses
Primary practice location
2075 W Big Beaver Rd
Suite 520
Troy, MI 48084-3407
Mailing address
2507 Edison St
Detroit, MI 48206-2044
Phone (616) 990-0105
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301016538 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaufman Psychological Services, PLLC | Current | 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.
-
- Psychologist
- Detroit, MI
- NPI 1356921282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490572800000",
"number": "1124337985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2507 EDISON ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482062044",
"telephone_number": "616-990-0105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2075 W BIG BEAVER RD",
"address_2": "SUITE 520",
"city": "TROY",
"state": "MI",
"postal_code": "480843407",
"telephone_number": "248-646-6659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "CALDER",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-28",
"last_updated": "2017-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301016538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.