Kellie Ann Whitlock

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301012614 Issued in MI

Practice address

29470 Robert Dr
Livonia, MI 48150-3039

Phone

(734) 525-3807

NPI assigned

Jun 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Other names 1

• Ms. Kellie Ann Bohlman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942405915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29470 ROBERT DR",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503039",
            "telephone_number": "734-525-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29470 ROBERT DR",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503039",
            "telephone_number": "734-525-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "KELLIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "BOHLMAN",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather R. Whiteman, P.T.
• Linda Whiteman, R.N.
• Blair Whitenton
• Mary Whitfield
• Megan Louise Whiting
• Melody Charmaine Whitsett
• Merrill R Whittaker Jr., PBMT
• Shamia N Whitten-Hunter
• Kenneth Whittum
• Whole Life Communication Services LLC

• Clinical Psychologist in Livonia, MI
• Providers in Livonia, MI by specialty
• Clinical Psychologist in Michigan

• 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.

Verify at the official NPI Registry.