Active NPI
Brandi N Vanklompenberg, MA
- Psychologist
- Detroit, MI
National Provider Identifier
1760961585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301016650
- Practice address
- 570 Clinton St
Detroit, MI 48226-2334 - Phone
- (313) 224-0706
- NPI assigned
- Aug 13, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301016650 | MI | Primary |
Addresses
Primary practice location
570 Clinton St
Detroit, MI 48226-2334
Mailing address
7561 NW 16TH St Apt 2208
Plantation, FL 33313-5127
Phone (616) 848-4361
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6301016650 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534118400000",
"number": "1760961585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7561 NW 16TH ST APT 2208",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333135127",
"telephone_number": "616-848-4361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "570 CLINTON ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482262334",
"telephone_number": "313-224-0706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANKLOMPENBERG",
"first_name": "BRANDI",
"middle_name": "N",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-13",
"last_updated": "2018-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301016650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.