Individual provider Active NPI

Kelly D Daunter, MA,LLP

  • Psychologist
  • Traverse City, MI
National Provider Identifier
1245563279
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301009805 Issued in MI
Practice address
512 S Union St
Traverse City, MI 49684-3247
Phone
(231) 941-6550
Fax
(231) 941-8981
NPI assigned
Sep 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301009805 MI Primary

Addresses

Primary practice location

512 S Union St
Traverse City, MI 49684-3247

Mailing address

512 S Union St
Traverse City, MI 49684-3247
Phone (231) 941-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140822000393 MI Practitioner - Clinical Psychologist 8426201708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

321 E Lake St
Suite 7
Petoskey, MI 49770-2459
Phone (231) 838-8560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Family Psychological Services, PLLC CurrentSince Jan 1, 2017 Accepting new patients
Old Town Psychological Services-Gaylord Past Accepting new patients

Locations

8430 M 119
Harbor Springs, MI 49740

321 E Lake St
Ste 7
Petoskey, MI 49770
Phone (231) 622-5460

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1245563279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 S UNION ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843247",
            "telephone_number": "231-941-6550",
            "fax_number": "231-941-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 S UNION ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843247",
            "telephone_number": "231-941-6550",
            "fax_number": "231-941-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUNTER",
        "first_name": "KELLY",
        "middle_name": "D",
        "credential": "MA,LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-09",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301009805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.