Individual provider Active NPI

James Johansen Kissinger, M.A. T.L.L.P

  • Counseling Psychologist
  • Ionia, MI
National Provider Identifier
1457549131
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6301013569 Issued in MI
Practice address
375 Apple Tree Dr
Ionia, MI 48846-7506
Phone
(616) 527-1790
NPI assigned
Oct 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6301013569 MI Primary

Addresses

Primary practice location

375 Apple Tree Dr
Ionia, MI 48846-7506

Mailing address

375 Apple Tree Dr
Ionia, MI 48846-7506
Phone (616) 527-1790

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
6301013569MIMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1457549131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 APPLE TREE DR",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "488467506",
            "telephone_number": "616-527-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 APPLE TREE DR",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "488467506",
            "telephone_number": "616-527-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSINGER",
        "first_name": "JAMES",
        "middle_name": "JOHANSEN",
        "credential": "M.A. T.L.L.P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301013569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ionia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.