Katherine Marie Kittredge, PSYD, PMH-C

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301019545 Issued in MI

Practice address

810 W Oxhill Dr
White Lake, MI 48386-2349

Phone

(248) 842-4794

NPI assigned

Oct 16, 2024

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 names 1

• Katherine Marie Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1669292397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W OXHILL DR",
            "city": "WHITE LAKE",
            "state": "MI",
            "postal_code": "483862349",
            "telephone_number": "248-842-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W OXHILL DR",
            "city": "WHITE LAKE",
            "state": "MI",
            "postal_code": "483862349",
            "telephone_number": "248-842-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTREDGE",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSYD, PMH-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301019545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "JOHNSON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karim Dental Group, PLLC
• Milad Said Karim, DDS
• Gloria Kato Karungi, PA-C
• Hilton Edward Kincaid
• Leah King
• Marcy Renee Kolb, LMSW
• Kristine Ann Krajewski, M.S., CCC/SLP
• Lacey Kreft, DPT
• Kroger Co of Michigan
• Lisa Kropp, B.A.

• Clinical Psychologist in White Lake, MI
• Providers in White Lake, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.