Active NPI
Sanela Kalakovic, TLLP
- Clinical Psychologist
- Kalamazoo, MI
National Provider Identifier
1689242638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6352000599
- Practice address
- 5320 Holiday Ter Ste 3
Kalamazoo, MI 49009-2100 - Phone
- (269) 459-1512
- Fax
- (269) 459-1514
- NPI assigned
- Jun 16, 2021
- Last updated
- Jun 16, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6352000599 | MI | Primary |
Addresses
Primary practice location
5320 Holiday Ter Ste 3
Kalamazoo, MI 49009-2100
Mailing address
5320 Holiday Ter Ste 3
Kalamazoo, MI 49009-2100
Phone (269) 459-1512
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6352000599 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revitalize Psychological Services, PLLC | Clinical | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Macomb, MI
- NPI 1942186010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1689242638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5320 HOLIDAY TER STE 3",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490092100",
"telephone_number": "269-459-1512",
"fax_number": "269-459-1514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5320 HOLIDAY TER STE 3",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490092100",
"telephone_number": "269-459-1512",
"fax_number": "269-459-1514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALAKOVIC",
"first_name": "SANELA",
"credential": "TLLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-16",
"last_updated": "2021-06-16",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6352000599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
- Mary E Kaiser, MSN, NP-C, CWOCN
- Tina M Kaiser, P.T.
- Ramsharan Kakani
- Pavan Kakarla
- Kal Kleen Inc
- Kalamazoo Academy for Behavioral and Academic Success (Kalamazoo Clinic for Behavioral Success)
- Kalamazoo Act Psychotherapy Services
- Kalamazoo Acute Care Specialists PLC
- Kalamazoo Anesthesiology P C
- Kalamazoo Area Rehabilitation Services PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.