Active NPI
Mitzi Marie Kalin, LLP
- Psychologist
- St Joseph, MI
National Provider Identifier
1255417267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301012953
- Practice address
- 2095 Niles Rd
St Joseph, MI 49085 - Phone
- (269) 983-4751
- Fax
- (269) 983-0803
- NPI assigned
- Oct 31, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301012953 | MI | Primary |
Addresses
Primary practice location
2095 Niles Rd
St Joseph, MI 49085
Mailing address
1915 Langley Ave
St Joseph, MI 49085
Phone (269) 983-7586
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301012953 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychology Associates, PC | Psychologist | 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.
-
- Psychologist
- Saint Joseph, MI
- NPI 1932241866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255417267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1915 LANGLEY AVE",
"city": "ST JOSEPH",
"state": "MI",
"postal_code": "49085",
"telephone_number": "269-983-7586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2095 NILES RD",
"city": "ST JOSEPH",
"state": "MI",
"postal_code": "49085",
"telephone_number": "269-983-4751",
"fax_number": "269-983-0803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALIN",
"first_name": "MITZI",
"middle_name": "MARIE",
"credential": "LLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301012953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Joseph, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.