MRS. KIMBERLY SIEKLUCKI (NPI# 1205258084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205258084 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY SIEKLUCKI |
| Practice Address |
5148 Lovers Ln Suite 2 Portage MI 49002-1572 |
| Practice Telephone | 2693433010 |
| Practice Fax Number | 2693433017 |
| Mailing Telephone | 2693433010 |
| Mailing Fax Number | 2693433017 |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2015-12-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
6301015819 | MI | Behavioral Health & Social Service Providers |
| Street Address |
5148 LOVERS LN SUITE 2 |
| City | PORTAGE |
| State | MI |
| Zip Code | 49002-1572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033169008 | Patricia Shull-blood | Psychologist | 5148 Lovers Ln, Suite 200, Portage, MI 49002-1572 | 2006-05-11 |
| 1487055323 | Amber Ostlund | Psychologist | 5148 Lovers Ln, Suite 2, Portage, MI 49002-1572 | 2014-09-10 |
| 1629000989 | Gentiva Certified Healthcare Corp. | Home Health | 5148 Lovers Ln, Suite 210, Portage, MI 49002-1572 | 2006-07-07 |
| 1386694909 | Stephanie Stewart | Psychologist | 5148 Lovers Ln, Suite 2, Portage, MI 49002-1572 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932604204 | Susan Vandewalker | Physical Therapist | 8001 Angling Rd., Portage, MI 49002 | 2018-03-28 |
| 1134634934 | Portage Chiropractic and Wellness Center | Chiropractor | 609 E. Centre, Portage, MI 49002 | 2017-12-04 |
| 1548620537 | Patricia Eid | Behavioral Analyst | 1016 E Milham Ave, Suite 2, Portage, MI 49002 | 2016-03-03 |
| 1386045383 | Pinnacle Senior Care of Kalamazoo, LLC | Home Health | 2725 Airview Blvd Ste 105b, Portage, MI 49002 | 2014-09-09 |
| 1104241611 | Meredith Ayers Holland | Behavioral Analyst | 9616 Portage Road, Portage, MI 49002 | 2014-02-20 |
| 1619211919 | Daketia L Thomas | Massage Therapist | 8314 Portage Rd, Suite D, Kalamazoo, MI 49002 | 2012-11-27 |
| 1831457142 | Kinetic Kids, LLC | Occupational Therapist | 540 East Milham, Portage, MI 49002 | 2012-04-25 |
| 1154689404 | Lauren Michelle Mattaliano | Occupational Therapist | 540 E. Milham Road, Portage, MI 49002 | 2012-04-24 |
| 1114219227 | South Michigan Psychiatric Services LLC | Psychiatry & Neurology | 5390 Lovers Ln, Third Floor, Portage, MI 49002 | 2011-05-07 |
| 1174836316 | Premier Neuropsychiatry Plc | Psychiatry & Neurology | 5930 Lovers Lane, Portage, MI 49002 | 2010-07-16 |
| Find all providers in zip 49002 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174147755 | Jane Ann Connon | Psychologist | 5619 Downing St, Portage, MI 49024-9519 | 2020-05-30 |
| 1912494592 | Hunter Counseling LLC | Psychologist | 5900 Portage Rd, Portage, MI 49002-1774 | 2018-04-18 |
| 1902226962 | Pamala Topp | Psychologist | 1504 Romence Rd, Portage, MI 49024-3470 | 2014-04-17 |
| 1407022874 | Andre Rubin Fields | Psychologist | 8175 Creekside Dr, Suite 264, Portage, MI 49024-5377 | 2008-05-05 |
| 1538234521 | Carole Marie Bullmer | Psychologist | 6100 Newport Rd Ste 222, Portage, MI 49002-9235 | 2006-11-22 |
| 1992292338 | Deerfield Counseling LLC | Psychologist | 5900 Portage Rd, Portage, MI 49002-1774 | 2018-04-20 |
| 1932507761 | Anastasiya Lutsenko | Psychologist | 5805 Oakland Dr, Portage, MI 49024-1118 | 2014-12-10 |
| 1487055323 | Amber Ostlund | Psychologist | 5148 Lovers Ln, Suite 2, Portage, MI 49002-1572 | 2014-09-10 |
| 1568737799 | Jessica A Kerby | Psychologist | 7320 Garden Ln, Portage, MI 49002-4423 | 2012-03-21 |
| 1518244011 | Michele Lynn Mcgrady | Psychologist | 1662 E Centre Ave, Portage, MI 49002-4496 | 2011-11-11 |
| Find all providers in PORTAGE | ||||
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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.