NPIMap

Organization Active NPI

Choices for Change

  • Counseling Psychologist
  • Kalamazoo, MI
National Provider Identifier
1376765743
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6301008528 Issued in MI
Legal business name
CHOICES FOR CHANGE
Practice address
218 W Walnut St
Kalamazoo, MI 49007-5131
Phone
(269) 344-7997
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Mrs. Alice Leonora Koss, MASTERS PSYCHOLOGIST
Title
Therapist
Phone
(269) 344-7997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X 6301008528 MI Primary

Addresses

Primary practice location

218 W Walnut St
Kalamazoo, MI 49007-5131

Mailing address

6418 Cypress Streeet
Portage, MI 49002
Phone (269) 327-3144

Other identifiers 1

IdentifierTypeStateIssuer
6301008528OtherMILIMITED LICENSED PSYCHOLO

National Provider Directory

National Provider Directory
Tax ID family
Choices for Change2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1376765743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 CYPRESS STREEET",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49002",
            "telephone_number": "269-327-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 W WALNUT ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075131",
            "telephone_number": "269-344-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICES FOR CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "KOSS",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "LEONORA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "269-344-7997",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MASTERS PSYCHOLOGIST"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301008528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIMITED LICENSED PSYCHOLO",
            "identifier": "6301008528",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.