Michael Kimball Integrative Psychotherapy

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

MICHAEL KIMBALL INTEGRATIVE PSYCHOTHERAPY

Practice address

6635 W Central Ave
Toledo, OH 43617-1029

Phone

(419) 517-0105

Fax

(419) 517-1349

NPI assigned

Jul 27, 2022

Organization subpart

No

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

Authorized official

Name

Michael Kimball, PSY.D.NPI 1316375595

Title

Clinical Psychologist

Phone

(734) 693-0554

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Kimball, PSY.D.

  • Clinical Psychologist
  • Toledo, OH
  • NPI 1316375595
  NPD Authorized official

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1346976891",
    "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": "734-693-0554",
            "fax_number": "419-517-1349"
        },
        {
            "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": "419-517-0105",
            "fax_number": "419-517-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL KIMBALL INTEGRATIVE PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "734-693-0554",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0294590",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "doc.michaelkimball@gmail.com",
            "affiliation": "N",
            "address_1": "6635 W Central Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436171029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nathan Meyers
• Patrick Roy Meyers, LSW
• Mariana Meza
• Mark Anthony Micale, PH.D.
• Michael a Poitinger DC LLC
• Cynthia Rae Michael, LISW
• Michelle Michael, RN
• Andrew Jay Michaelis
• Linda Suzanne Michaels, PHD
• Tara Lyn Michaels

• Adult Mental Health Clinic/Center in Toledo, OH
• Providers in Toledo, OH by specialty
• Adult Mental Health Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.