Kristine Elizabeth Wilmoth, MS, LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301014161 Issued in MI

Practice address

700 Hammond Rd E Ste 200
Traverse City, MI 49686-8641

Phone

(231) 947-2255

NPI assigned

Nov 7, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristine Elizabeth Wilmoth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1134558463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HAMMOND RD E STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496868641",
            "telephone_number": "231-947-2255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Silver Dr",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496845749",
            "country_code": "US",
            "telephone_number": "231-947-2255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILMOTH",
        "first_name": "KRISTINE",
        "middle_name": "ELIZABETH",
        "credential": "MS, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014161",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "WILMOTH",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shania Willingham
• Alexis Willms
• Grace Willow, N.C.T.M.B.
• Lindsay Sea Wills, LLPC
• Ifayemi Willson
• Abbigale Joan Ellyn Wilson, M.D.
• Allison Renee Wilson, MS, LPC
• Hannah Marie Wilson, PA
• Jocelyn Wilson
• Krysten Rose Wilson, PA-C

• All providers in Traverse City, MI
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.