Paul Phelps Sr., MAR

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401004079 Issued in MI

Practice address

4200 W Michigan Ave Ste 243
Kalamazoo, MI 49006-5840

Phone

(269) 375-2833

Fax

(269) 375-2838

NPI assigned

Aug 24, 2007

Last updated

Aug 24, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bethesda Counseling Sevices LLC

  • Clinical Psychologist
  • Kalamazoo, MI
  • NPI 1487873659

  Professional

  NPD (past) Authorized official

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187913600000",
    "number": "1417140179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10040 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490099426",
            "telephone_number": "269-375-2833",
            "fax_number": "269-375-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W MICHIGAN AVE STE 243",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490065840",
            "telephone_number": "269-375-2833",
            "fax_number": "269-375-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "PAUL",
        "name_suffix": "Sr.",
        "credential": "MAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401004079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Dominic Pezzillo, MD
• Patricia Ann Pfau, P.A.-C.
• Sara Paige Pfeil
• Bradley Phares, DDS, MS
• Phelps Partners, PC
• Shelly Marie Phelps, M.A. TLLP
• Jennifer Philburn, DO
• Mary Philipp, MA, LLP
• Phillip T. Doyle DDS PC
• Maryann Phillippi, MD

• Professional Counselor in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; 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.