Amy Kristine Byerley, PHD
Individual provider Active NPI Clinical Psychologist · Rockford, MI
NPI 1144577396 · NPPES record last updated Nov 6, 2024
Key facts
- NPI
- 1144577396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 6301015025 (MI)
- Practice address
- 9011 N Wolven Ridge CT
Rockford, MI 49341-9384 - Phone
- (616) 902-2404
- NPI assigned
- Aug 7, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120918000877 | MI | Practitioner - Clinical Psychologist | 5799933677 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301015025 | MI | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301015025 | MI | Yes |
Addresses
Primary practice location
9011 N Wolven Ridge CT
Rockford, MI 49341-9384
Mailing address
9011 N Wolven Ridge CT
Rockford, MI 49341-9384
Other providers in Rockford, MI
- Brian Bundy
- Jessica Brooke Burgess
- Kevin M Burkhart
- Brandon Ryan Burns
- Sandra Burns
- Byrne Chiropractic LLC
- Steve Byrne
- Heather J Cadorette
- Allison Viviana Calabrese
- Alicia Kathleen Cameron
All providers in Rockford, MI · Clinical Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.