Active NPI
Kate Caddy, PSY.D.
- Clinical Psychologist
- Waterford, MI
National Provider Identifier
1730635285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301012229
- Practice address
- 1255 N Oakland Blvd
Waterford, MI 48327-1545 - Phone
- (248) 406-0090
- NPI assigned
- Aug 25, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 6301012229 | MI | Primary |
Addresses
Primary practice location
1255 N Oakland Blvd
Waterford, MI 48327-1545
Mailing address
1255 N Oakland Blvd
Waterford, MI 48327-1545
Phone (248) 406-0090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6301015559 | Other | MI | STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS, BOARD OF PSYCH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301012229 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Health & Wellness Associates | 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.
-
- Counselor
- Farmington Hills, MI
- NPI 1801348420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472083200000",
"number": "1730635285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1255 N OAKLAND BLVD",
"city": "WATERFORD",
"state": "MI",
"postal_code": "483271545",
"telephone_number": "248-406-0090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 N OAKLAND BLVD",
"city": "WATERFORD",
"state": "MI",
"postal_code": "483271545",
"telephone_number": "248-406-0090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CADDY",
"first_name": "KATE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-25",
"last_updated": "2016-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301012229",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS, BOARD OF PSYCH",
"identifier": "6301015559",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.