Active NPI
Ray Lynn Kaidbay, DTLLP
- Clinical Psychologist
- Southfield, MI
National Provider Identifier
1699551366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6352000774
- Practice address
- 17515 W 9 Mile Rd Ste 240
Southfield, MI 48075-4423 - Phone
- (248) 579-2188
- NPI assigned
- Sep 7, 2023
- 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 | 6352000774 | MI | Primary |
Addresses
Primary practice location
17515 W 9 Mile Rd Ste 240
Southfield, MI 48075-4423
Mailing address
49982 Ash CT
Plymouth, MI 48170-6380
Phone (734) 890-0920
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 |
|---|---|---|---|
| 6352000774 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robin McCoy Ms | Past | 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 and National Provider Directory roles.
-
- Psychologist
- Southfield, MI
- NPI 1861945123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1699551366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49982 ASH CT",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481706380",
"telephone_number": "734-890-0920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17515 W 9 MILE RD STE 240",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754423",
"telephone_number": "248-579-2188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAIDBAY",
"first_name": "RAY",
"middle_name": "LYNN",
"credential": "DTLLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-07",
"last_updated": "2023-09-07",
"certification_date": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6352000774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.