MRS. KRIS SANDRA NICOLICH (NPI# 1790203750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790203750 |
| Entity Type | Individual |
| Full Name | MRS. KRIS SANDRA NICOLICH |
| Credential | LLP |
| Practice Address |
3258 Broad St Dexter MI 48130-1142 |
| Mailing Address |
3265 Eastridge Dr Dexter MI 48130-9392 |
| Practice Telephone | 7347184579 |
| Mailing Telephone | 7347184579 |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2017-08-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
6301011113 | MI | Behavioral Health & Social Service Providers |
| Street Address |
3258 BROAD ST |
| City | DEXTER |
| State | MI |
| Zip Code | 48130-1142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346533346 | Martin Dwayne Fletcher | Psychologist | 3258 Broad St, Dexter, MI 48130-1142 | 2011-05-24 |
| 1275024671 | Laura Victoria Shipley | Psychologist | 3258 Broad St, Dexter, MI 48130-1142 | 2018-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013497585 | Julie Anne Bumpus X | Nurse Practitioner | 4848 Gregory, Dexter, MI 48130 | 2018-08-15 |
| 1255726592 | Alliance for Hope and Healing | Psychologist | 8005 Main St., Dexter, MI 48130 | 2015-04-03 |
| 1588979926 | Beata Malgorzata Jagoda-ohman | Physical Therapist | 7057 Dexter-ann Arbor Rd, Dexter, MI 48130 | 2010-08-10 |
| 1639317514 | Thrive Chiropractic Dexter P.C. | Preferred Provider Organization | 3219 Broad St, Suite 106, Dexter, MI 48130 | 2009-01-30 |
| 1083888622 | Alan Stephen Boyce | Chiropractor | 3151 Baker Rd, Dexter, MI 48130 | 2008-04-15 |
| 1720200785 | Brenda Denise Eisele | Speech-Language Pathologist | 3630 Noble Drive, Dexter, MI 48130 | 2007-05-02 |
| 1104041649 | Robert Joseph Turck | Dentist | 3060 Baker Rd, Dexter, MI 48130 | 2007-04-17 |
| 1073647343 | Amy Alexandra Whitney | Pharmacist | 7080 Dexter- Ann Arbor Rd, Dexter, MI 48130 | 2007-03-16 |
| 1457481442 | John Douglas Higgins | Audiologist | 7900 W Huron River Dr, Dexter, MI 48130 | 2007-03-07 |
| 1235264425 | Boyce Dc Pllc | Chiropractor | 3151 Baker Road, Dexter, MI 48130 | 2007-02-21 |
| Find all providers in zip 48130 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386656023 | Terry L Braciszewski | Psychologist | 7926 Ann Arbor St, Dexter, MI 48130-1344 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820598 | Alexander William Krieg | Psychologist | 31235 Ramble Rd, Franklin, MI 48025-1367 | 2020-10-26 |
| 1699389395 | Linda D Seltzer-sucher Phd LLC | Psychologist | 275 Bryn Mawr St, Birmingham, MI 48009-1501 | 2020-09-01 |
| 1780154435 | Erica Griffis Prime | Psychologist | 28066 Sunset Blvd W, Lathrup Village, MI 48076-2658 | 2018-11-26 |
| 1932600772 | Grand Blanc Psychology Pllc | Psychologist | 8382 Holly Rd Ste 1, Grand Blanc, MI 48439-1972 | 2018-02-27 |
| 1649792292 | Livingston Psychological Services, Pllc | Psychologist | 204 W Grand River Ave Ste 260, Howell, MI 48843 | 2017-07-14 |
| 1720529779 | Dannison | Psychologist | 604 S Rose St, Kalamazoo, MI 49007 | 2017-03-10 |
| 1912356254 | Maurice Moses Jr. | Psychologist | 541 Walbridge Dr, East Lansing, MI 48823-2039 | 2016-06-07 |
| 1538531017 | Life Journey Pllc | Psychologist | 2013 East Castle Drive Sw, Suite B, Grand Rapids, MI 49508 | 2015-10-23 |
| 1548654148 | Darya Owens | Psychologist | 1235 Saint Clair St, Detroit, MI 48214-3671 | 2015-03-23 |
| 1538582671 | Laura Ann Wyglinski, Ph. D. | Psychologist | 4675 Okemos Rd, Okemos, MI 48864-1974 | 2014-01-25 |
| Find all providers with the same taxonomy | ||||
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| 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.