Active NPI
Andrew Peter Kronk, PH.D.
- Clinical Psychologist
- Allen Park, MI
National Provider Identifier
1588738975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301002148
- Practice address
- 6735 Park Ave
Allen Park, MI 48101-2033 - Phone
- (313) 407-7456
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301002148 | MI | Primary |
Addresses
Primary practice location
6735 Park Ave
Allen Park, MI 48101-2033
Mailing address
801 N Mildred St
Dearborn, MI 48128-1732
Phone (313) 565-8885
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301002148 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436227200000",
"number": "1588738975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 N MILDRED ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481281732",
"telephone_number": "313-565-8885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6735 PARK AVE",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "481012033",
"telephone_number": "313-407-7456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRONK",
"first_name": "ANDREW",
"middle_name": "PETER",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2015-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301002148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.