Kathryn J Roaleen, M.A,, L L.P.,

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301009417 Issued in MI

Practice address

5039 10 Mile Rd NE
Rockford, MI 49341-9301

Phone

(616) 866-4514

NPI assigned

Feb 9, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Ionia County Community Mental Health

  • Public Health or Welfare Agency
  • Ionia, MI
  • NPI 1760452122
  NPD (past)

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234137600000",
    "number": "1700025152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5039 10 MILE RD NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419301",
            "telephone_number": "616-866-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5039 10 MILE RD NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419301",
            "telephone_number": "616-866-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROALEEN",
        "first_name": "KATHRYN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "M.A,, L L.P.,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301009417",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802018463",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald P Riebschleger, DDS
• Zakary Riebschleger
• Rite Aid of Michigan Inc
• Riverside Counseling, LLC
• Sara Roach, PT, DPT, CBIS
• Robert Dejonge DO PC
• Robinet Physical Therapy
• Barbara Robinet
• Jason Robinet, P.T.
• Rockford Ambulance Inc

• Clinical Psychologist in Rockford, MI
• Providers in Rockford, 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 9, 2009; 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.