DR. CHRISTIAN ROBERT KOMOR


Address: 235 Louis St Nw, Grand Rapids, MI 49503-2600
Phone: 6167066951

DR. CHRISTIAN ROBERT KOMOR (NPI# 1225409220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225409220
Entity Type Individual
Full Name DR. CHRISTIAN ROBERT KOMOR
Credential PSY.D.
Practice Address 235 Louis St Nw
Grand Rapids
MI 49503-2600
Mailing Address 428 Childers St
Pmb 24256
Pensacola
FL 32534-9630
Practice Telephone 6167066951
Mailing Telephone 6167066951
Enumeration Date 2015-10-15
Last Update Date 2016-09-14
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist 6301005480 MI Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI CHAMPUS M032644 01
MI OD14598 05

Office Location

Street Address 235 LOUIS ST NW
City GRAND RAPIDS
State MI
Zip Code 49503-2600

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1477176949 Kimberly Buskirk Specialist 1131 Ionia Ava Nw, Grand Rapids, MI 49503 2020-05-19
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1194368647 Amy Jo Arends Nurse Practitioner 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 2019-10-28
1376185199 Beth Arce Occupational Therapist 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 2019-10-14
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1205490240 Maxwell Taylor Psychologist 401 Hall St Sw Ste 112b, Grand Rapids, MI 49503-4988 2019-04-25
1760995146 Stephanie Elizabeth Karek Psychologist 4467 Cascade Rd Se Ste A4469, Grand Rapids, MI 49546-3791 2017-11-08
1114447745 Andrea Gumbko Psychologist 3403 Michigan St Ne, Grand Rapids, MI 49525-3408 2017-06-24
1720529332 Clearwater Counseling & Wellness LLC Psychologist 1525 E Beltline Se, Grand Rapids, MI 49525-4598 2017-03-15
1851748768 Heather Dermyer, LLC Psychologist 3330 Centennial Rdg, #205, Grand Rapids, MI 49546-7098 2016-05-20
1902265234 Lauren Conkright Psychologist 1009 44th St Se, Suite 103, Grand Rapids, MI 49508 2016-02-15
1780022194 Gregory V Mallis Psychologist 1870 Leonard St Se, Grand Rapids, MI 49505-5650 2013-06-07
1821344136 Laura Ann Doughty Psychologist 800 Monroe Ave Nw Ste 206, Grand Rapids, MI 49503-1448 2012-07-24
1528321296 Mikhila N Wildey Psychologist 300 58th St Se, Grand Rapids, MI 49548-5984 2012-06-19
1952699415 Heart of The City Psychologist 540 Cherry St Se, Grand Rapids, MI 49503-4748 2011-07-19
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Competitor

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City GRAND RAPIDS
Zip Code 49503

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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