Individual provider Active NPI

Kevin Carl Elmore, MA, LLP

  • Psychologist
  • Okemos, MI
National Provider Identifier
1770651283
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6361006349 Issued in MI
Practice address
2149 Jolly Rd Ste 500
Okemos, MI 48864-6028
Phone
(517) 347-4645
Fax
(517) 347-4644
NPI assigned
Dec 1, 2006
Last updated
Jan 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6361006349 MI Primary

Addresses

Primary practice location

2149 Jolly Rd Ste 500
Okemos, MI 48864-6028

Mailing address

2149 Jolly Rd Ste 500
Okemos, MI 48864-6028
Phone (517) 347-4645

Other practice location 1

209 E Washington Ave Ste 205
Jackson, MI 49201-2393
Phone (517) 648-2416

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
6361006349MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Karen Gallagher LMSW Acsw Professional Counseling SRVS LLC PastSince Jan 1, 2009 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, 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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1770651283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 JOLLY RD STE 500",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646028",
            "telephone_number": "517-347-4645",
            "fax_number": "517-347-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 JOLLY RD STE 500",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646028",
            "telephone_number": "517-347-4645",
            "fax_number": "517-347-4644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 E Washington Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492012393",
            "country_code": "US",
            "telephone_number": "517-648-2416",
            "fax_number": "517-347-4644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "KEVIN",
        "middle_name": "CARL",
        "credential": "MA, LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361006349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.