Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kathleen Piccoli, PSYD

Individual provider Psychologist · NPI 1871267930

Dr. Kathleen Piccoli, PSYD is a Clinical Psychologist in Grand Rapids, Michigan. Qualified in 2021, 5 years ago. Practices with Mary Free Bed Rehabilitation Hospital, a 132-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado and Michigan.

Years since qualifying
5
Licensed in
CO, MI
In the registry since
2021
Specialties on file
3
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone: (616) 840-8668
Fax: (616) 840-9762
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1550 3 Mile Rd Nw Ste C, Grand Rapids, MI 49544-8251 — (616) 840-8807

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 6301019499 (MI)
Psychologist Taxonomy 103T00000X · Licence 0006030 (CO)
Clinical Psychologist Taxonomy 103TC0700X · Licence 6301019499 (MI)

Record details

NPI number1871267930
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorNo
NPI enumeratedAugust 3, 2021
Last updated in NPPESFebruary 3, 2025
Certification dateFebruary 3, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Mary Free Bed Rehabilitation Hospital — 132 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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