Individual provider Active NPI

Kristen Kay Roesler, MA, LLP

  • Cognitive & Behavioral Psychologist
  • White Cloud, MI
National Provider Identifier
1366892010
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
6301009558 Issued in MI
Practice address
1049 E Newell St
White Cloud, MI 49349-8795
Phone
(231) 689-7330
Fax
(231) 689-7345
NPI assigned
Jun 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 6301009558 MI Primary

Addresses

Primary practice location

1049 E Newell St
White Cloud, MI 49349-8795

Mailing address

1049 E Newell St
White Cloud, MI 49349-8795
Phone (231) 689-7330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6301009558MIMDCognitive & Behavioral Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1366892010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 E NEWELL ST",
            "city": "WHITE CLOUD",
            "state": "MI",
            "postal_code": "493498795",
            "telephone_number": "231-689-7330",
            "fax_number": "231-689-7345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 E NEWELL ST",
            "city": "WHITE CLOUD",
            "state": "MI",
            "postal_code": "493498795",
            "telephone_number": "231-689-7330",
            "fax_number": "231-689-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESLER",
        "first_name": "KRISTEN",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "MA, LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6301009558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Cloud, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.