Kim Therese Pauwels, M.A., LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6361002044 Issued in MI

Practice address

8245 Holly Rd Ste 200
Grand Blanc, MI 48439-2483

Phone

(800) 693-1916

NPI assigned

Nov 9, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Green Pastures Therapy LLC

  • Social Worker
  • Swartz Creek, MI
  • NPI 1205564978
  NPD
• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1710214945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 KURTZ RD",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484428314",
            "telephone_number": "248-790-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8245 HOLLY RD STE 200",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392483",
            "telephone_number": "800-693-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUWELS",
        "first_name": "KIM",
        "middle_name": "THERESE",
        "credential": "M.A., LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-09",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301013202",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361002044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Romeka Patton-Lane
• Tristen Paul
• Tara Pauley, MSW
• Jennifer Marie Paulisin
• Chelsea Paull
• Agnieszka Zuzanna Pawlowska, MD
• Peace of Mind Therapy Services PLLC
• Terri Lynn Peace, CRNA
• Eboni Pearce, MD
• Lori Jean Pearce, R.N.

• Psychologist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.