Individual provider Active NPI

William Douglas Brooks, ED.D.

  • Counseling Psychologist
  • Kalamazoo, MI
National Provider Identifier
1497860092
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
2557 Issued in MI
Practice address
4415 Duke St
Kalamazoo, MI 49008-3224
Phone
(269) 349-1799
Fax
(269) 349-1820
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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 2557 MI Primary

Addresses

Primary practice location

4415 Duke St
Kalamazoo, MI 49008-3224

Mailing address

4415 Duke St
Kalamazoo, MI 49008-3224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071010000451 MI Practitioner - Clinical Psychologist 4880580737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

690 Airway Dr
Suite 211
Allegan, MI 49010-9563
Phone (269) 349-1799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2557MIMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell and Brooks 1, PC Counseling CurrentSince Jul 26, 2007 Accepting new patients
Kalamazoo Psychology, LLC Counseling Past Accepting new patients
Steven L Keyte DPM PC PastSince Jan 1, 2008 Accepting new patients

Locations

690 Airway Dr
Allegan, MI 49010
Phone (269) 349-1799

4415 Duke St
Kalamazoo, MI 49008
Phone (269) 342-0201

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1497860092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 DUKE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490083224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 DUKE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490083224",
            "telephone_number": "269-349-1799",
            "fax_number": "269-349-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "WILLIAM",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "2557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.