Mark McKelvy Garner, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301006596 Issued in MI

Practice address

12935 S West Bay Shore Dr Ste 260
Traverse City, MI 49684-5597

Phone

(231) 642-1641

NPI assigned

Nov 29, 2006

Last updated

Jan 11, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Insight Behavioral Wellness of Northern Michigan LLC

  • Clinical Psychologist
  • Traverse City, MI
  • NPI 1942790894
  NPD (past)
• Management & Behavior Consultants, P. C.

  • Clinical Psychologist
  • Traverse City, MI
  • NPI 1306071071
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1558438838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12935 S WEST BAY SHORE DR STE 260",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845597",
            "telephone_number": "231-642-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12935 S WEST BAY SHORE DR STE 260",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845597",
            "telephone_number": "231-642-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNER",
        "first_name": "MARK",
        "middle_name": "MCKELVY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301006596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUSTRICARE",
            "identifier": "M025581",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN BLUE CROSS BLUE SHIELD",
            "identifier": "68-0-B8-4791",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "68-0-B8-4791",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Jill Gannon, PEER RECOVERY COACH
• Marla Diane Garchow, DCP
• Samantha Garcia, LMSW - C
• Shauna Jo Gardner
• Suzanne Marie Gareiss, LPC
• Sandra Garnett
• Joseph L Garrity, LMSW - CAC - 1
• Patrick Thomas Gartland, M.D.
• Sara Sue Gartland
• Gary S Ruoff DO PC

• Clinical Psychologist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.