Active NPI
Kathleen Ann Andrulis, M.A., L.L.P.
- Clinical Psychologist
- Warren, MI
National Provider Identifier
1215067962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301004072
- Practice address
- 3701 E 13 Mile Rd Ste B
Warren, MI 48092-3795 - Phone
- (586) 274-0200
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301004072 | MI | Primary |
Addresses
Primary practice location
3701 E 13 Mile Rd Ste B
Warren, MI 48092-3795
Mailing address
3701 E 13 Mile Rd Ste B
Warren, MI 48092-3795
Phone (586) 274-0200
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 |
|---|---|---|---|
| 6301004072 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Macomb County Community Mental Health | 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.
-
- Community/Behavioral Health Agency
- Warren, MI
- NPI 1770610834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335916800000",
"number": "1215067962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 E 13 MILE RD STE B",
"city": "WARREN",
"state": "MI",
"postal_code": "480923795",
"telephone_number": "586-274-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 E 13 MILE RD STE B",
"city": "WARREN",
"state": "MI",
"postal_code": "480923795",
"telephone_number": "586-274-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRULIS",
"first_name": "KATHLEEN",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "M.A., L.L.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2012-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301004072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.