| Kristin Roberts Psychological Services Llc | |
|
532 Ethel Ave Se Grand Rapids MI 49506-2724 | |
| (616) 706-4765 | |
| Not Available |
| Full Name | Kristin Roberts Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 532 Ethel Ave Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Kristin Elizabeth Roberts (OWNER) |
| Authorized Official Contact | 6167064765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristin Roberts Psychological Services Llc 532 Ethel Ave Se Grand Rapids MI 49506-2724 Ph: (616) 706-4765 | Kristin Roberts Psychological Services Llc 532 Ethel Ave Se Grand Rapids MI 49506-2724 Ph: (616) 706-4765 |
| NPI Number | 1295550457 |
|---|---|
| Provider Enumeration Date | 11/21/2024 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/21/2024 |
| Medicare PECOS PAC ID | 7214467273 |
|---|---|
| Medicare Enrollment ID | O20250206001891 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295550457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Kristin M Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801211107 PECOS PAC ID: 4880130905 Enrollment ID: I20240731001475 |
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