Individual provider Active NPI

Sofia Kazulkina, MA, LLP

  • Psychologist
  • Ann Arbor, MI
National Provider Identifier
1578839346
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301014551 Issued in MI
Practice address
2201 Hogback Rd
Ann Arbor, MI 48105-9732
Phone
(734) 973-4863
NPI assigned
Mar 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301014551 MI Primary

Addresses

Primary practice location

2201 Hogback Rd
Ann Arbor, MI 48105-9732

Mailing address

PO Box 915
Ypsilanti, MI 48197-0915
Phone (734) 544-3000

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
6301014551MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Begin Within PLLC Current Accepting new patients
County of Washtenaw Past Accepting new patients
Washtenaw Community Health Organization Past Accepting new patients

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": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1578839346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 915",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481970915",
            "telephone_number": "734-544-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HOGBACK RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059732",
            "telephone_number": "734-973-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZULKINA",
        "first_name": "SOFIA",
        "name_prefix": "Ms.",
        "credential": "MA, LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.