Kari Coburn, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301010816 Issued in MI

Practice address

1750 S. Telegraph Road
Suite 101
Bloomfield Hills, MI 48302-0177

Phone

(248) 451-9085

NPI assigned

Jan 27, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1871865535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 S. TELEGRAPH ROAD",
            "address_2": "SUITE 101",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020177",
            "telephone_number": "248-451-9085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 S. TELEGRAPH ROAD",
            "address_2": "SUITE 101",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020177",
            "telephone_number": "248-451-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "KARI",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301010816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Teresa Lee Coletta Rea, PA-C
• Michael D. Colman, M.D.
• Comforcare Senior Services, Inc.

• Clinical Psychologist in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.