Individual provider Active NPI

Lauren Vanessa Kachorek, PH.D.

  • Psychologist
  • Ann Arbor, MI
National Provider Identifier
1710994926
Registry record updated Nov 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LK012912 Issued in MI
Practice address
1915 Suffolk St
Ann Arbor, MI 48103-5019
Phone
(248) 867-4550
NPI assigned
Aug 1, 2006
Last updated
Nov 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301012912 MI
Psychologist 103T00000X LK012912 MI Primary

Addresses

Primary practice location

1915 Suffolk St
Ann Arbor, MI 48103-5019

Mailing address

1915 Suffolk St
Ann Arbor, MI 48103-5019
Phone (248) 867-4550

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201230002199 MI Practitioner - Clinical Psychologist 8325451867 Practice locations: Ann Arbor, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LK012912MIMDPsychologist
6301012912MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren V. Kachorek, PH.D., PLLC Clinical CurrentSince Nov 10, 2024 Accepting new patients
Lauren V. Kachorek, PH.D., PLLC Clinical CurrentSince Nov 10, 2024 Accepting new patients
Alpha Psychological Services, P.C. Psychologist PastSince Oct 11, 2012 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730592000000",
    "number": "1710994926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 SUFFOLK ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035019",
            "telephone_number": "248-867-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 SUFFOLK ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035019",
            "telephone_number": "248-867-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACHOREK",
        "first_name": "LAUREN",
        "middle_name": "VANESSA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012912",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "LK012912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.