Organization Active NPI

Kaufman Psychological Services, PLLC

  • Psychologist
  • Detroit, MI
National Provider Identifier
1356921282
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
KAUFMAN PSYCHOLOGICAL SERVICES, PLLC
Practice address
511 Beaubien St # 8
Detroit, MI 48226-4309
Phone
(616) 990-0105
NPI assigned
Apr 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Authorized official

Name
Dr. Calder William Kaufman, PSYDNPI 1124337985
Title
Owner
Phone
(616) 990-0105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

511 Beaubien St # 8
Detroit, MI 48226-4309

Mailing address

511 Beaubien St # 8
Detroit, MI 48226-4309

National Provider Directory

National Provider Directory

Locations

511 Beaubien St
#8
Detroit, MI 48226
Phone (616) 990-0105

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1356921282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 BEAUBIEN ST # 8",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 BEAUBIEN ST # 8",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264309",
            "telephone_number": "616-990-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAUFMAN PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "KAUFMAN",
        "authorized_official_first_name": "CALDER",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-990-0105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.