Organization Active NPI

Clinical Psychology Services, PLLC

  • Adult Mental Health Clinic/Center
  • Kalamazoo, MI
National Provider Identifier
1962807644
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
CLINICAL PSYCHOLOGY SERVICES, PLLC
Practice address
350 E Michigan Ave
Suite 135
Kalamazoo, MI 49007-3800
Phone
(269) 206-1480
Fax
(269) 366-4946
NPI assigned
Oct 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Authorized official

Name
Ms. Margaret O Ajayi-Nabors, PHDNPI 1336311257
Title
Owner
Phone
(269) 206-1480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MI Primary

Addresses

Primary practice location

350 E Michigan Ave
Suite 135
Kalamazoo, MI 49007-3800

Mailing address

350 E Michigan Ave
Suite 135
Kalamazoo, MI 49007-3800
Phone (269) 206-1480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141211002000 MI Part B Supplier - Clinic/Group Practice 9537481007 Receives reassigned benefits from 2 practitioners
Practice locations: Portage, MI

National Provider Directory

National Provider Directory

Locations

350 E Michigan Ave
Ste 135
Kalamazoo, MI 49007
Phone (269) 206-1480

1400 W Milham Ave
Portage, MI 49024
Phone (269) 312-8686

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1962807644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E MICHIGAN AVE",
            "address_2": "SUITE 135",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073800",
            "telephone_number": "269-206-1480",
            "fax_number": "269-366-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E MICHIGAN AVE",
            "address_2": "SUITE 135",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073800",
            "telephone_number": "269-206-1480",
            "fax_number": "269-366-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL PSYCHOLOGY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "AJAYI-NABORS",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-206-1480",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.