Rebecca A Klott, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301015303 Issued in MI

Practice address

1000 Monroe Ave NW
Grand Rapids, MI 49503-1455

Phone

(616) 259-7207

Fax

(616) 259-7261

NPI assigned

Jun 17, 2011

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

River City Psychological Services PCGroup PAC ID 2769606979, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• River City Psychological Services PC

  • Clinical Psychologist
  • Grand Rapids, MI
  • NPI 1235557844
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1689969651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MONROE AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031455",
            "telephone_number": "616-259-7207",
            "fax_number": "616-259-7261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONROE AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031455",
            "telephone_number": "616-259-7207",
            "fax_number": "616-259-7261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "233 Fulton St E Ste 24",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495033262",
            "country_code": "US",
            "telephone_number": "616-204-5828",
            "fax_number": "616-235-2099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLOTT",
        "first_name": "REBECCA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Klooster
• Kelsey Nicole Kloosterman, NP
• Megan Kloska, OTRL
• Klott Psychological Services PLLC
• John O Klott
• KLS Counseling LLC
• Allyson Klug, DPT
• Samuel Blake Kluger, MD
• Michele Klunder
• David Edwin Klungle, PA-C

• Clinical Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.