MEDICARE: KERBY PSYCHOLOGICAL SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	6301015083	MI

General Provider Information

NPI Number	:	1285017244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KERBY PSYCHOLOGICAL SERVICES PLLC

Provider Business Mailing Address
First Line	:	7862 PRIMROSE LN
Second Line	:
City	:	PORTAGE
State	:	MI
Zip	:	49024-4966
Country	:	US
Telephone Number	:	269-569-2216
Fax Number	:

Provider Business Practice Location Address
First Line	:	4017 W MAIN ST STE 100
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49006-3731
Country	:	US
Telephone Number	:	269-205-8772
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PSYCHOLOGIST
Name	:	DR. JESSICA A KERBY
Credential	:	PH.D, LP
Telephone Number	:	269-569-2216

Provider Enumeration Date	:	07/08/2015
Last Update Date	:	09/12/2025

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