Active NPI
Kyle Wawrzyniec
- Psychologist
- Auburn Hills, MI
National Provider Identifier
1306252770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301015945
- Practice address
- 1270 Doris Rd
Auburn Hills, MI 48326-2617 - Phone
- (248) 276-8000
- NPI assigned
- Jul 7, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 6301015945 | MI | Primary |
Addresses
Primary practice location
1270 Doris Rd
Auburn Hills, MI 48326-2617
Mailing address
18600 Northville Rd
Northville, MI 48168-3544
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 |
|---|---|---|---|
| 6301015945 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414713600000",
"number": "1306252770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18600 NORTHVILLE RD",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481683544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1270 DORIS RD",
"city": "AUBURN HILLS",
"state": "MI",
"postal_code": "483262617",
"telephone_number": "248-276-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAWRZYNIEC",
"first_name": "KYLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-07",
"last_updated": "2014-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301015945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.