Tiffany Lynn Born, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3514-57 Issued in WI

Practice address

555 Redbird Cir Ste 100
De Pere, WI 54115-7978

Phone

(920) 338-6830

Fax

(920) 445-7289

NPI assigned

Jun 9, 2015

Last updated

Feb 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bellin Memorial Hospital Inc

  dba Bellin Health Algoma

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment NPD
• Bellin Psychiatric Center Inc

  dba Bellin Behavior Health Bellevue Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1952554800
  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health Center for Asthma and Allergy

  • Allergy & Immunology Physician
  • Green Bay, WI
  • NPI 1316286941
  NPD
• Bellin Psychiatric Center Inc

  dba Bellin Behavior Health Bond Health Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oconto, WI
  • NPI 1609050798

  Psychologist

  NPD
• Bellin Psychiatric Center Inc.

  dba Bellin Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1598728776

  Psychologist

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1023498649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E SAINT JOSEPH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012241",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 REDBIRD CIR STE 100",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541157978",
            "telephone_number": "920-338-6830",
            "fax_number": "920-445-7289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212051832",
            "country_code": "US",
            "telephone_number": "443-923-1872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 E Saint Joseph St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543012241",
            "country_code": "US",
            "telephone_number": "920-433-6073",
            "fax_number": "920-431-0333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORN",
        "first_name": "TIFFANY",
        "middle_name": "LYNN",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3514-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobbie Jo Lee Bleser, CSAC, LPC
• Marilyn Elizabeth Bohatkiewicz, PHD
• Kenneth William Bond
• Bonnie M Lee & Associates
• Sarah Books, BCBA
• Ryan Patrick Bourdelais
• Morgan Bowers, BCBA
• Dan J Braaten, LMFT, SAC
• Robert G Brady, PT
• Sherri Ann Brandenburg, RN

• Psychologist in De Pere, WI
• Providers in De Pere, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.