Karla Marie Averill, MA,LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6361003377 Issued in MI

Practice address

890 N 10TH St
Kalamazoo, MI 49009-6192

Phone

(269) 427-8400

NPI assigned

Jun 19, 2020

Last updated

Jun 19, 2020By the provider in NPPES

Sex

Female

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 1

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

Locations

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.

• Beacon Specialized Living New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Kalamazoo, MI
  • NPI 1013615269
  NPD

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1669098224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 BRUTUS RD",
            "city": "BRUTUS",
            "state": "MI",
            "postal_code": "497169710",
            "telephone_number": "623-337-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 N 10TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490096192",
            "telephone_number": "269-427-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERILL",
        "first_name": "KARLA",
        "middle_name": "MARIE",
        "credential": "MA,LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361003377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12345",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Auro Physical Therapy, PLC
• Megan Austin
• Nikki Austin, LMT
• Mikelis Austrins, D.D.S.
• Cody Michael Autrey, MD
• Lisa Carr Avery, MSW
• Ayomide Awodeji, MD
• Roland Olasunkanmi Awolope
• Mariam Ayad
• Emily Ayers, LMSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.