Active NPI
Michelle Kruz
- Clinical Psychologist
- Oak Park, MI
National Provider Identifier
1942876859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6362009427
- Practice address
- 25900 Greenfield Rd Ste 100
Oak Park, MI 48237-1297 - Phone
- (248) 788-4300
- NPI assigned
- Jun 1, 2021
- Last updated
- Jan 18, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6362009427 | MI | Primary |
| Art Therapist | 221700000X |
Addresses
Primary practice location
25900 Greenfield Rd Ste 100
Oak Park, MI 48237-1297
Mailing address
16564 Quakertown LN
Livonia, MI 48154-1167
Phone (313) 312-5958
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6362009427 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705536000000",
"number": "1942876859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16564 QUAKERTOWN LN",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481541167",
"telephone_number": "313-312-5958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25900 GREENFIELD RD STE 100",
"city": "OAK PARK",
"state": "MI",
"postal_code": "482371297",
"telephone_number": "248-788-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUZ",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-01",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6362009427",
"primary": true
},
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.