Active NPI
M Lane Kelemen, PH.D.
- Clinical Psychologist
- Ann Arbor, MI
National Provider Identifier
1861690521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301008936
- Practice address
- 120 E Liberty St
Suite 310
Ann Arbor, MI 48104-2156 - Phone
- (734) 665-0959
- NPI assigned
- Jul 4, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301008936 | MI | Primary |
Addresses
Primary practice location
120 E Liberty St
Suite 310
Ann Arbor, MI 48104-2156
Mailing address
120 E Liberty St
Suite 310
Ann Arbor, MI 48104-2156
Phone (734) 665-0959
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008936 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465776000000",
"number": "1861690521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 E LIBERTY ST",
"address_2": "SUITE 310",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481042156",
"telephone_number": "734-665-0959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 E LIBERTY ST",
"address_2": "SUITE 310",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481042156",
"telephone_number": "734-665-0959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELEMEN",
"first_name": "M",
"middle_name": "LANE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-04",
"last_updated": "2016-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301008936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.