DR. KIMBERLY GERISSE VANDALE (PH.D.) – Psychologist, NPI 1053633974

DR. KIMBERLY GERISSE VANDALE (PH.D.) is a healthcare provider. based in Mount clemens, Michigan. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 6301014352 (MI). The NPI Number for DR. KIMBERLY GERISSE VANDALE (PH.D.) is 1053633974

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
DR. KIMBERLY GERISSE VANDALE (PH.D.)
NPI
1053633974
Phone
(586) 465-4444
Address
116 MARKET ST
Enumeration Date
19 February 2010
Last Update Date
9 February 2011

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5864654444
Graduation Year
2007 (19 years ago)
PAC ID
9830343359
Group Practice PAC ID
4183633753
Professional Enrollment ID
I20130211000381
Address ID
MI480435674MO116XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

1,216 CLINICAL PSYCHOLOGIST in MI

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Provider Addresses for DR. KIMBERLY GERISSE VANDALE (PH.D.)

  • Perceptions Counseling Services, P.C., 116, Market Street, Mount Clemens Downtown Loop, Mount Clemens, Macomb County, Michigan, 48043, United States

    PERCEPTIONS COUNSELING SERVICES

    MOUNT CLEMENS, MI 480435674

    Phone: (586) 465-4444

    Fax: (586) 783-2761

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-02-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130211000381IClinical PsychologistMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48043)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183633753View full group profile
NameSpecialtyState
Clinical PsychologistMI

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Frequently asked questions

Does DR. KIMBERLY GERISSE VANDALE (PH.D.) have a public NPI I can cite?
Public records show DR. KIMBERLY GERISSE VANDALE (PH.D.) under NPI 1053633974.
Does the public listing show DR. KIMBERLY GERISSE VANDALE (PH.D.) as active?
DR. KIMBERLY GERISSE VANDALE (PH.D.)'s NPI record reflects an active status in NPPES.
Which specialty label fits DR. KIMBERLY GERISSE VANDALE (PH.D.)?
NPPES ties DR. KIMBERLY GERISSE VANDALE (PH.D.) to Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. KIMBERLY GERISSE VANDALE (PH.D.)?
DR. KIMBERLY GERISSE VANDALE (PH.D.) shows a connection to Mount Clemens, Michigan in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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