Individual provider Active NPI

Brady Richard Harnishfeger, PHD

  • Clinical Psychologist
  • Kalamazoo, MI
National Provider Identifier
1316976830
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301008153 Issued in 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
Last updated
Dec 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301008153 MI Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20080320000182 MI Practitioner - Clinical Psychologist 5799868675 Practice locations: Kalamazoo, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1316976830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8228 HERITAGE DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490099613",
            "telephone_number": "269-544-0286",
            "fax_number": "269-341-9735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W MAPLE ST",
            "address_2": "STE 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490085800",
            "telephone_number": "269-341-9745",
            "fax_number": "269-341-9735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARNISHFEGER",
        "first_name": "BRADY",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301008153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.