Brady Richard Harnishfeger, PHD
Individual provider Active NPI Clinical Psychologist · Kalamazoo, MI
NPI 1316976830 · NPPES record last updated Dec 7, 2016
Key facts
- NPI
- 1316976830
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 6301008153 (MI)
- Practice address
- 1011 W Maple St
Ste 200
Kalamazoo, MI 49008-5800 - Phone
- (269) 341-9745
- Fax
- (269) 341-9735
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080320000182 | MI | Practitioner - Clinical Psychologist | 5799868675 | Practice locations: Kalamazoo, MI |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301008153 | MI | Yes |
Addresses
Primary practice location
1011 W Maple St
Ste 200
Kalamazoo, MI 49008-5800
Mailing address
8228 Heritage Dr
Kalamazoo, MI 49009-9613
Phone (269) 544-0286
Other providers in Kalamazoo, MI
- Nanette Marie Haring
- Zachary Turk Harling
- Sydney Harmon
- Kelsey Laray Harness
- Julie Ann Harning
- Harold and Grace Upjohn Community Care Center
- Daisia Harper
- Jessica Harper
- Anne Elizabeth Harrelson
- Amanda Harrington
All providers in Kalamazoo, MI · Clinical Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.