Active NPI
Kathy Ann Polansky-Dettling, MA, LLP
- Counseling Psychologist
- Howell, MI
National Provider Identifier
1902963085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6301008650
- Practice address
- 2280 E Grand River Ave
Howell, MI 48843-8503 - Phone
- (517) 546-4126
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6301008650 | MI | Primary |
Addresses
Primary practice location
2280 E Grand River Ave
Howell, MI 48843-8503
Mailing address
2280 E Grand River Ave
Howell, MI 48843-8503
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008650 | MI | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902963085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2280 E GRAND RIVER AVE",
"city": "HOWELL",
"state": "MI",
"postal_code": "488438503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2280 E GRAND RIVER AVE",
"city": "HOWELL",
"state": "MI",
"postal_code": "488438503",
"telephone_number": "517-546-4126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLANSKY-DETTLING",
"first_name": "KATHY",
"middle_name": "ANN",
"credential": "MA, LLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301008650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Howell, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.