Kenfield Walters Intl LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

6301006592 Issued in MI

Legal business name

KENFIELD WALTERS INTL LLC

Practice address

38864 Country Cir
Farmington Hills, MI 48331-1025

Phone

(248) 737-0388

NPI assigned

Dec 10, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Judith Christina Walters, PH.D.NPI 1235209339

Title

Ceo

Phone

(248) 737-0388

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judith Christina Walters

  • Clinical Psychologist
  • West Bloomfield, MI
  • NPI 1235209339
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1134550510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38864 COUNTRY CIR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483311025",
            "telephone_number": "248-737-0388",
            "fax_number": "248-254-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38864 COUNTRY CIR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483311025",
            "telephone_number": "248-737-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENFIELD WALTERS INTL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "CHRISTINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-737-0388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MI",
            "license": "6301006592",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MI",
            "license": "4101005991",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaida Kendrick
• Leah Kendrick
• Rachel Kenealy
• Maddison Kenefsky
• Nancy Kenessey
• Gisele Kengmo
• Thabringna Kennebrew
• Alexis Kennedy
• Briannia Kennedy
• De'Ja Kennedy

• Adult Mental Health Clinic/Center in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Adult Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; 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.