Individual provider Active NPI

Dalia Boussi

  • Psychologist
  • Kalamazoo, MI
National Provider Identifier
1710858485
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6352001177 Issued in MI
Practice address
5708 Venture CT Ste B
Kalamazoo, MI 49009-2858
Phone
(269) 459-1818
NPI assigned
Sep 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6352001177 MI Primary

Addresses

Primary practice location

5708 Venture CT Ste B
Kalamazoo, MI 49009-2858

Mailing address

5708 Venture CT Ste B
Kalamazoo, MI 49009-2858
Phone (269) 459-1818

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

LicenseStateTypeSpecialty
6352001177MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Meredith Psychological and Testing Services, LLC CurrentSince Sep 21, 2025 Accepting new patients

Locations

5708 Venture Ct
Ste B
Kalamazoo, MI 49009
Phone (269) 459-1818

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.

NPI Registry JSON

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

{
    "created_epoch": "1757980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1710858485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5708 VENTURE CT STE B",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092858",
            "telephone_number": "269-459-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5708 VENTURE CT STE B",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092858",
            "telephone_number": "269-459-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSSI",
        "first_name": "DALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-16",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6352001177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.