Individual provider Active NPI

Kella Hayward, MA, LLP

  • Psychologist
  • Plymouth, MI
National Provider Identifier
1740826965
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6361008113 Issued in MI
Practice address
496 W Ann Arbor TRL Ste 202
Plymouth, MI 48170-6262
Phone
(734) 414-1373
NPI assigned
Nov 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6361008113 MI Primary

Addresses

Primary practice location

496 W Ann Arbor TRL Ste 202
Plymouth, MI 48170-6262

Mailing address

5934 Edinburgh St Apt 104
Canton, MI 48187-4574
Phone (989) 854-5009

Other practice location 1

3830 Packard St Ste 280
Ann Arbor, MI 48108-2276
Phone (734) 224-2454

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6361008113MIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1740826965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5934 EDINBURGH ST APT 104",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874574",
            "telephone_number": "989-854-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 W ANN ARBOR TRL STE 202",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706262",
            "telephone_number": "734-414-1373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3830 Packard St Ste 280",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481082276",
            "country_code": "US",
            "telephone_number": "734-224-2454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYWARD",
        "first_name": "KELLA",
        "credential": "MA, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361008113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.