Active NPI
Katherine G Pastoor, MA, LLP
- Psychologist
- Kentwood, MI
National Provider Identifier
1770129009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301017840
- Practice address
- 436 44TH St SE Ste C
Kentwood, MI 49548-4371 - Phone
- (616) 460-6896
- NPI assigned
- Nov 21, 2019
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301017840 | MI | Primary |
Addresses
Primary practice location
436 44TH St SE Ste C
Kentwood, MI 49548-4371
Mailing address
453 Greenmeadow CT SE
Caledonia, MI 49316-8050
Phone (616) 460-6896
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 |
|---|---|---|---|
| 6301017840 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574294400000",
"number": "1770129009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "453 GREENMEADOW CT SE",
"city": "CALEDONIA",
"state": "MI",
"postal_code": "493168050",
"telephone_number": "616-460-6896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "436 44TH ST SE STE C",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495484371",
"telephone_number": "616-460-6896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASTOOR",
"first_name": "KATHERINE",
"middle_name": "G",
"credential": "MA, LLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-21",
"last_updated": "2019-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301017840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kentwood, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.