Individual provider Active NPI

Kambiz Alavi, PHD.

  • Clinical Psychologist
  • Houghton, MI
National Provider Identifier
1669796983
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301007704 Issued in MI
Practice address
901 W Mem Dr
Houghton, MI 49931-2475
Phone
(906) 482-9400
Fax
(906) 482-9794
NPI assigned
Mar 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301007704 MI Primary

Addresses

Primary practice location

901 W Mem Dr
Houghton, MI 49931-2475

Mailing address

901 W Mem Dr
Houghton, MI 49931-2475
Phone (906) 482-9400

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301007704MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1669796983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MEM DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312475",
            "telephone_number": "906-482-9400",
            "fax_number": "906-482-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MEM DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312475",
            "telephone_number": "906-482-9400",
            "fax_number": "906-482-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAVI",
        "first_name": "KAMBIZ",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houghton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.