Individual provider Active NPI

Cleopas Allan Kaliati

  • Psychologist
  • Kalamazoo, MI
National Provider Identifier
1780456244
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6361006494 Issued in MI
Practice address
157 S Kalamazoo Mall Ste 250
Kalamazoo, MI 49007-4828
Phone
(269) 383-1440
Fax
(269) 383-9781
NPI assigned
Oct 26, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6361006494 MI
Clinical Child & Adolescent Psychologist 103TC2200X 6361006494 MI
Psychologist 103T00000X 6361006494 MI Primary

Addresses

Primary practice location

157 S Kalamazoo Mall Ste 250
Kalamazoo, MI 49007-4828

Mailing address

6023 Litchfield LN
Kalamazoo, MI 49009-9128
Phone (269) 760-8553

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

State licenses

LicenseStateTypeSpecialty
6361006494MIMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Place Counseling & Associate PLC Psychologist CurrentSince Oct 29, 2023 Accepting new patients
TLS Litchfield, LLC PastSince Oct 29, 2023 Accepting new patients

Locations

157 S Kalamazoo Mall
Ste 250
Kalamazoo, MI 49007
Phone (269) 383-1440

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1780456244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6023 LITCHFIELD LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490099128",
            "telephone_number": "269-760-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 S KALAMAZOO MALL STE 250",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074828",
            "telephone_number": "269-383-1440",
            "fax_number": "269-383-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIATI",
        "first_name": "CLEOPAS",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6361006494",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6361006494",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361006494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.