Individual provider Active NPI

Katherine Alison Melchior, PHD

  • Clinical Psychologist
  • Livonia, MI
National Provider Identifier
1528482155
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014731 Issued in MI
Practice address
17199 N Laurel Park Dr
Ste 306
Livonia, MI 48152-7904
Phone
(734) 589-3048
NPI assigned
Feb 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301014731 MI Primary

Addresses

Primary practice location

17199 N Laurel Park Dr
Ste 306
Livonia, MI 48152-7904

Mailing address

17199 N Laurel Park Dr Ste 306
Livonia, MI 48152-7904
Phone (734) 589-3048

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
I20140401001284 MI Practitioner - Clinical Psychologist 6406087659 Reassigns benefits to 1 organization
Practice locations: Livonia, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19855 Outer Dr
Suite 103
Dearborn, MI 48124-2022
Phone (734) 589-3048

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301014731MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Katherine a Melchior PHD LLC CurrentSince Oct 15, 2018 Accepting new patients
Orchard Hills Psychiatric Center, PC Past Accepting new patients

Locations

19855 Outer Dr
Ste 103
Dearborn, MI 48124
Phone (313) 278-6099

17199 N Laurel Park Dr
Ste 306
Livonia, MI 48152
Phone (734) 589-3048

17199 N Laurel Park Dr
#K
Livonia, MI 48152
Phone (734) 589-3048

Organizations & group practices 2

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": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1528482155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17199 N LAUREL PARK DR STE 306",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481527904",
            "telephone_number": "734-589-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17199 N LAUREL PARK DR",
            "address_2": "STE 306",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481527904",
            "telephone_number": "734-589-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELCHIOR",
        "first_name": "KATHERINE",
        "middle_name": "ALISON",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.