Katherine K Gorncy, TLLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6361007710 Issued in MI

Practice address

504 E 4TH St
Royal Oak, MI 48067-2847

Phone

(313) 356-6878

NPI assigned

Oct 22, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Katherine K Hofmeyer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Mind in Bloom PLLC

  • Clinical Psychologist
  • Royal Oak, MI
  • NPI 1134811318
  NPD Authorized official

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1346883477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 E 4TH ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672847",
            "telephone_number": "313-356-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 E 4TH ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672847",
            "telephone_number": "313-356-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORNCY",
        "first_name": "KATHERINE",
        "middle_name": "K",
        "credential": "TLLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361007710",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301018210",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "HOFMEYER",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Gorczynski
• Gordina Dialysis LLC
• Shoshana Gordon, DO
• Gregory Albert Gorga, DDS
• Diann Gorguze, CRNA
• Gabriela Mirela Gorog, M.D.
• Maggie Patricia Gorski, NP
• Alexander Gosselin, DO
• Lisa Marie Gostiaux
• Peter Gottschalk, CRNA

• Clinical Psychologist in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.