Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kala Ann Pozivilko, PMHNP-C

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1669042990

Kala Ann Pozivilko, PMHNP-C is a Nurse Practitioner in Grand Rapids, Michigan. Qualified in 2021, 5 years ago. Practices with Saginaw County Community Mental Health Authority, a 25-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
5
Licensed in
MI
In the registry since
2021
Specialties on file
3
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Practice location Address checks out

790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone: (616) 336-3909
Fax: (616) 336-8830
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 175 N Groesbeck Hwy, Mount Clemens, MI 48043-1562 — (616) 301-8000

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 2021035112 (MI)
Nurse Practitioner Taxonomy 363L00000X · Licence 4704326670 (MI)
Adult Psychiatric/Mental Health Clinical Nurse Specialist Taxonomy 364SP0809X · Licence 4704326670 (MI)

Record details

NPI number1669042990
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-C
Sole proprietorNo
NPI enumeratedJune 29, 2021
Last updated in NPPESFebruary 16, 2026
Certification dateFebruary 16, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Saginaw County Community Mental Health Authority — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Grand Rapids