Individual provider Active NPI

Kaarin Anderson Ryan, PH.D.

  • Clinical Psychologist
  • Grand Haven, MI
National Provider Identifier
1881911279
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014390 Issued in MI
Practice address
41 Washington Ave Ste 368
Grand Haven, MI 49417-1378
Phone
(616) 843-1196
Fax
(631) 261-6052
NPI assigned
Apr 26, 2010
Last updated
Dec 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 6301014390 MI
Cognitive & Behavioral Psychologist 103TB0200X 02419201 NY
Clinical Psychologist 103TC0700X 6301014390 MI Primary
Clinical Psychologist 103TC0700X 02419201 NY
Clinical Child & Adolescent Psychologist 103TC2200X 6301014390 MI
Clinical Child & Adolescent Psychologist 103TC2200X 02419201 NY
Intellectual & Developmental Disabilities Psychologist 103TM1800X 6301014390 MI
Intellectual & Developmental Disabilities Psychologist 103TM1800X 02419201 NY
Behavior Analyst 103K00000X 11518751 NY
Behavior Analyst 103K00000X 11518751 MI

Addresses

Primary practice location

41 Washington Ave Ste 368
Grand Haven, MI 49417-1378

Mailing address

410 Fort Salonga Rd
Northport, NY 11768-3046
Phone (631) 262-8561

Other practice location 1

410 Fort Salonga Rd
Northport, NY 11768-3046
Phone (631) 262-8561

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

LicenseStateTypeSpecialty
11518751MIMDBehavioral Analyst
11518751NYMDBehavioral Analyst
6301014390MIMDClinical Child & Adolescent Psychologist
02419201NYMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Behavior Support Consulting & Psychological Resources PC Behavior Analyst CurrentSince Dec 21, 2025 Accepting new patients

Locations

41 Washington Ave
Ste 368
Grand Haven, MI 49417
Phone (616) 638-8830

410 Fort Salonga Rd
Northport, NY 11768
Phone (631) 262-8561

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1881911279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 FORT SALONGA RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117683046",
            "telephone_number": "631-262-8561",
            "fax_number": "631-261-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WASHINGTON AVE STE 368",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171378",
            "telephone_number": "616-843-1196",
            "fax_number": "631-261-6052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Fort Salonga Rd",
            "address_purpose": "LOCATION",
            "city": "Northport",
            "state": "NY",
            "postal_code": "117683046",
            "country_code": "US",
            "telephone_number": "631-262-8561",
            "fax_number": "631-261-6052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON RYAN",
        "first_name": "KAARIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6301014390",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "02419201",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014390",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "02419201",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301014390",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "02419201",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301014390",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "02419201",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "11518751",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "11518751",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.