Active NPI
Kevin Jay Tolsma, MS, LLP
- Psychologist
- Jackson, MI
National Provider Identifier
1821253832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301010703
- Practice address
- 6692 Spring Arbor Rd
Jackson, MI 49201-9322 - Phone
- (517) 750-3869
- NPI assigned
- Jul 20, 2008
- Sex
- Male
- 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 | 6301010703 | MI | Primary |
Addresses
Primary practice location
6692 Spring Arbor Rd
Jackson, MI 49201-9322
Mailing address
3601 Hendee Rd
Jackson, MI 49201-9836
Phone (517) 841-0115
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301010703 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216512000000",
"number": "1821253832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 HENDEE RD",
"city": "JACKSON",
"state": "MI",
"postal_code": "492019836",
"telephone_number": "517-841-0115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6692 SPRING ARBOR RD",
"city": "JACKSON",
"state": "MI",
"postal_code": "492019322",
"telephone_number": "517-750-3869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLSMA",
"first_name": "KEVIN",
"middle_name": "JAY",
"credential": "MS, LLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-20",
"last_updated": "2008-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301010703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.