Individual provider Active NPI

Lance Richard Kuebler, M.S., T.L.L.P.

  • Psychologist
  • Clinton Township, MI
National Provider Identifier
1962719732
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
L1845892 Issued in MI
Practice address
44899 Centre CT Ste 102
Clinton Township, MI 48038-5510
Phone
(586) 792-1654
Fax
(586) 792-1656
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X L1845892 MI Primary

Addresses

Primary practice location

44899 Centre CT Ste 102
Clinton Township, MI 48038-5510

Mailing address

15535 Lakeside Village Dr Apt 306
Clinton Township, MI 48038-6019
Phone (734) 262-1492

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 Science

State licenses

LicenseStateTypeSpecialty
L1845892MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Macomb Past Accepting new patients
Joak American Homes, Inc. PastSince Sep 8, 2009 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1962719732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15535 LAKESIDE VILLAGE DR APT 306",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386019",
            "telephone_number": "734-262-1492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44899 CENTRE CT STE 102",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385510",
            "telephone_number": "586-792-1654",
            "fax_number": "586-792-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEBLER",
        "first_name": "LANCE",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "M.S., T.L.L.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "L1845892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.