Kala Ann Pozivilko, PMHNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2021035112 Issued in MI

Practice address

790 Fuller Ave NE
Grand Rapids, MI 49503-1918

Phone

(616) 336-3909

Fax

(616) 336-8830

NPI assigned

Jun 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saginaw County Community Mental Health AuthorityGroup PAC ID 7719037332, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Saginaw County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Saginaw, MI
  • NPI 1689778953
  Medicare reassignment Care Compare group NPD
• Alternative Community Living, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Saginaw, MI
  • NPI 1114131729
  Medicare reassignment NPD
• County of Macomb

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clinton TWP, MI
  • NPI 1942532197
  Medicare reassignment NPD
• Hope Network - Rehabilitation Services

  • Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
  • Grand Rapids, MI
  • NPI 1528043544
  Medicare reassignment NPD
• Hope Network Behavioral Health Services

  • Mental Illness Community Based Residential Treatment Facility
  • Nunica, MI
  • NPI 1043295934
  Medicare reassignment NPD
• Hope Network S E

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Flint, MI
  • NPI 1609859537
  Medicare reassignment NPD
• Hope Network West Michigan

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Sparta, MI
  • NPI 1679558670
  Medicare reassignment NPD
• Kent County CMH Authority

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1588935068
  Medicare reassignment NPD
• Alternative Community Living, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Flint, MI
  • NPI 1164718441
  NPD
• Alternative Community Living, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Flint, MI
  • NPI 1609083872
  NPD
• County of Macomb

  • Public Health or Welfare Agency
  • Mount Clemens, MI
  • NPI 1760462253
  NPD
• Kent County CMH Authority

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1194617811
  NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1669042990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 FULLER AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031918",
            "telephone_number": "616-336-3909",
            "fax_number": "616-336-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 FULLER AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031918",
            "telephone_number": "616-336-3909",
            "fax_number": "616-336-8830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 N Groesbeck Hwy",
            "address_purpose": "LOCATION",
            "city": "Mount Clemens",
            "state": "MI",
            "postal_code": "480431562",
            "country_code": "US",
            "telephone_number": "616-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POZIVILKO",
        "first_name": "KALA",
        "middle_name": "ANN",
        "credential": "PMHNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "2021035112",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704326670",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MI",
            "license": "4704326670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.network180.x@direct.mihin.net",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "790 Fuller Ave NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495031918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David D Powers, RPH
• Jason Powers, LLPC
• Robert Powers
• Victoria Maria Powers, NCC, LPC
• David Pozivilko, MD
• Lindsay Porritt Peirce Poziwilko, LPC
• Samantha Praeger
• Jeffrey Prange
• Nancy J. Pranger, M.D.
• Teri Prashek

• Psychiatric/Mental Health Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.