Active NPI
Elizabeth Ann Decker-Hasan, L.L.P, L.P.C.
- Psychologist
- Kalamazoo, MI
National Provider Identifier
1306020037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6361004298
- Practice address
- 3217 Greenleaf Blvd Ste D
Kalamazoo, MI 49008-2596 - Phone
- (269) 339-0557
- NPI assigned
- Dec 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401009590 | MI | |
| Psychologist | 103T00000X | 6361004298 | MI | Primary |
Addresses
Primary practice location
3217 Greenleaf Blvd Ste D
Kalamazoo, MI 49008-2596
Mailing address
3217 Greenleaf Blvd Ste D
Kalamazoo, MI 49008-2596
Phone (269) 359-0557
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 |
|---|---|---|---|
| 6401009590 | MI | MD | Professional Counselor |
| 6361004298 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgeway Wellness Counseling | Professional | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1306020037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3217 GREENLEAF BLVD STE D",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490082596",
"telephone_number": "269-359-0557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3217 GREENLEAF BLVD STE D",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490082596",
"telephone_number": "269-339-0557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECKER-HASAN",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"credential": "L.L.P, L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-17",
"last_updated": "2024-09-23",
"certification_date": "2024-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401009590",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6361004298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.