Individual provider Active NPI

Angela Kudzia, LLP

  • Psychologist
  • Troy, MI
National Provider Identifier
1437964533
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6361002402 Issued in MI
Practice address
363 W Big Beaver Rd
Troy, MI 48084-5220
Phone
(586) 855-2683
NPI assigned
Feb 7, 2025
Last updated
Feb 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6361002402 MI Primary

Addresses

Primary practice location

363 W Big Beaver Rd
Troy, MI 48084-5220

Mailing address

15442 Roxbury Cir
Macomb, MI 48044-3866
Phone (586) 855-2683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251021000676 MI Practitioner - Psychologist Billing Independently 0345737607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

363 W Big Beaver Rd
Suite 400
Troy, MI 48084-5242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6361002402MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nexus Behavioral Health PLLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

363 W Big Beaver Rd
Ste 400
Troy, MI 48084
Phone (248) 509-7657

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1738886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1437964533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15442 ROXBURY CIR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480443866",
            "telephone_number": "586-855-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 W BIG BEAVER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480845220",
            "telephone_number": "586-855-2683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDZIA",
        "first_name": "ANGELA",
        "credential": "LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361002402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.