Active NPI
Kenneth T Montemayor, MS
- Clinical Psychologist
- Ann Arbor, MI
National Provider Identifier
1225913445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6352001070
- Practice address
- 3135 Professional Dr
Ann Arbor, MI 48104-5131 - Phone
- (248) 206-0486
- NPI assigned
- Aug 7, 2025
- Sex
- Male
- 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 | 6352001070 | MI | Primary |
Addresses
Primary practice location
3135 Professional Dr
Ann Arbor, MI 48104-5131
Mailing address
4001 W McNichols Rd
Detroit, MI 48221-3038
Phone (313) 578-0570
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6352001070 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754870400000",
"number": "1225913445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 W MCNICHOLS RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482213038",
"telephone_number": "313-578-0570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3135 PROFESSIONAL DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481045131",
"telephone_number": "248-206-0486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTEMAYOR",
"first_name": "KENNETH",
"middle_name": "T",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-07",
"last_updated": "2025-08-11",
"certification_date": "2025-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6352001070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.