Individual provider Active NPI

Kyler Woodford Mulhauser, PHD

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1780005587
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301018802 Issued in MI
Practice address
2101 Commonwealth Blvd Ste C
Ann Arbor, MI 48105-2969
Phone
(734) 764-0231
NPI assigned
Dec 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166.000954 IL
Clinical Psychologist 103TC0700X 6301018802 MI Primary

Addresses

Primary practice location

2101 Commonwealth Blvd Ste C
Ann Arbor, MI 48105-2969

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

600 W. Roosevelt Rd
Suite A2
Wheaton, IL 60187
Phone (630) 462-8810 ext. 3

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220112000432 MI Practitioner - Clinical Psychologist 9739571381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

2101 Commonwealth Blvd
Ann Arbor, MI 48105-2969
Phone (734) 763-9259

700 Woodland Dr
Saline, MI 48176-1620
Phone (734) 429-2302

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
166.000954ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Michigan PastSince Dec 1, 2020 Accepting new patients
Mark Macdonald & Associates, PC Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1780005587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COMMONWEALTH BLVD STE C",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052969",
            "telephone_number": "734-764-0231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W. Roosevelt Rd",
            "address_2": "Suite A2",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "60187",
            "country_code": "US",
            "telephone_number": "630-462-8810 x3",
            "fax_number": "630-462-8820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULHAUSER",
        "first_name": "KYLER",
        "middle_name": "WOODFORD",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-20",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.000954",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.