Kristin Dallaire, MA, LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301018325 Issued in MI

Practice address

1440 Torrey Rd Ste E
Fenton, MI 48430-1340

Phone

(616) 439-0392

NPI assigned

Aug 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristin Micheal Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Dallaire Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Burton, MI
  • NPI 1801506936
  NPD Authorized official

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1609320084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 N RIVER ST STE A",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303815",
            "telephone_number": "616-439-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 TORREY RD STE E",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484301340",
            "telephone_number": "616-439-0392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Robert T Longway Blvd",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485032190",
            "country_code": "US",
            "telephone_number": "810-496-4955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALLAIRE",
        "first_name": "KRISTIN",
        "credential": "MA, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301018325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "MICHEAL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lacee Jo Cripe
• Amy Michelle Culbert, LMSW
• Cynthia Louise Cupal, OPTOMETRIST
• Thomas Frederick Curran, PH.D.
• Christy Marie Daenzer, LLMSW
• Niketa Dani, MD
• Daniel Steinhardt PC
• Sherry Daniels, M.A., LPC, NCC
• Kimberly Darish
• Darkness Recovery, LLC

• Psychologist in Fenton, MI
• Providers in Fenton, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.