Kristin Roberts Psychological Services LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

KRISTIN ROBERTS PSYCHOLOGICAL SERVICES LLC

Practice address

532 Ethel Ave SE
Grand Rapids, MI 49506-2724

Phone

(616) 706-4765

NPI assigned

Nov 21, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Kristin Elizabeth Roberts, PHDNPI 1801211107

Title

Owner

Phone

(616) 706-4765

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristin Elizabeth Roberts

  • Psychologist
  • Grand Rapids, MI
  • NPI 1801211107
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1295550457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 ETHEL AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062724",
            "telephone_number": "616-706-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 ETHEL AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062724",
            "telephone_number": "616-706-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN ROBERTS PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-21",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-706-4765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.