Active NPI
Jennifer L Patterson, TLLP
- Psychologist
- Livonia, MI
National Provider Identifier
1013237346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301014160
- Practice address
- 31500 Schoolcraft Rd
Livonia, MI 48150-1805 - Phone
- (734) 422-9340
- Fax
- (734) 422-9353
- NPI assigned
- Jun 9, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301014160 | MI | Primary |
Addresses
Primary practice location
31500 Schoolcraft Rd
Livonia, MI 48150-1805
Mailing address
31500 Schoolcraft Rd
Livonia, MI 48150-1805
Phone (734) 422-9340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 750910681 | Other | MI | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301014160 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276041600000",
"number": "1013237346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31500 SCHOOLCRAFT RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481501805",
"telephone_number": "734-422-9340",
"fax_number": "734-422-9353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31500 SCHOOLCRAFT RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481501805",
"telephone_number": "734-422-9340",
"fax_number": "734-422-9353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "JENNIFER",
"middle_name": "L",
"credential": "TLLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-09",
"last_updated": "2010-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301014160",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "750910681",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.