Michael Kimball, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

07781 Issued in OH

Practice address

6635 W Central Ave
Toledo, OH 43617-1029

Phone

(734) 693-0554

Fax

(419) 517-1349

NPI assigned

Oct 24, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  OH, Psychologist

  Medicare reassignment NPD
• Michael Kimball Integrative Psychotherapy

  • Adult Mental Health Clinic/Center
  • Toledo, OH
  • NPI 1346976891
  NPD Authorized official
• Sound Mind Behavioral Wellness

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1043846165
  Medicare reassignment
• Sound Mind Behavioral Wellness, LLC

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1619581915
  NPD
• Heron Ridge Associates PLC

  • Counselor
  • Brighton, MI
  • NPI 1144810946

  Psychologist

  NPD (past)

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1316375595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7040 MONROE ST",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435601923",
            "telephone_number": "734-454-3560",
            "fax_number": "734-454-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6635 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171029",
            "telephone_number": "734-693-0554",
            "fax_number": "419-517-1349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 S Main St",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MI",
            "postal_code": "481702089",
            "country_code": "US",
            "telephone_number": "734-454-3560",
            "fax_number": "734-454-3570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5726 Southwyck Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436141510",
            "country_code": "US",
            "telephone_number": "419-214-1766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "MICHAEL",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-24",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014600",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "07781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0294590",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Van LTD.
• Kyu B. Kim, M.D.
• Tasha M Kim, PA
• Tricia Kim, DO
• Victoria Kimani
• Brandi Kimbrough, QBHS
• Eric T Kimchi, M.D.
• Stephen Kime
• Timothy Q Kime, O.D.
• Kevin Kimmel

• Clinical Psychologist in Toledo, OH
• Providers in Toledo, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.