Ellen I Koch, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301011802 Issued in MI

Practice address

2040 Grand River Anx Ste 300
Brighton, MI 48114-5313

Phone

(734) 678-4522

Fax

(734) 547-8940

NPI assigned

Feb 8, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• McCaskill Family Services

  • Mental Health Counselor
  • Plymouth, MI
  • NPI 1538602784
  NPD (past)

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1407214232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8436 BARRINGTON DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481989495",
            "telephone_number": "734-678-4522",
            "fax_number": "734-547-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 GRAND RIVER ANX STE 300",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481145313",
            "telephone_number": "734-678-4522",
            "fax_number": "734-547-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "ELLEN",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301011802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celine Mary Klecker, LPC
• Melanie Klenk, CNP
• Lisa Marie Klink, R.N.
• Roberta Ann Knittle, PA-C
• June Ko
• Debbie Koeltzow, EDD, LP
• Carly Komaromi
• Jacqueline Lee Konley, LMSW
• Kor Chiro Studio PLLC
• Siddhika B Kore, PT

• Clinical Psychologist in Brighton, MI
• Providers in Brighton, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.