Sierra Gillis

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6352000029 Issued in MI

Practice address

15000 Gratiot Ave
Detroit, MI 48205-1973

Phone

(313) 423-3067

NPI assigned

Jul 29, 2020

Sex

Female

Sole proprietor

Yes

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 MI

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

Specialty

Clinical Psychologist

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Mini Mitten Pediatric Therapy, LLC

  • Occupational Therapist
  • Monroe, MI
  • NPI 1528655826
  Medicare reassignment NPD
• Fairsky Foundation

  • Multi-Specialty Clinic/Center
  • Ferndale, MI
  • NPI 1033595665

  Psychologist

  NPD (past)

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1033728613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45773 BRYN MAWR RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875431",
            "telephone_number": "734-626-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051973",
            "telephone_number": "313-423-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "SIERRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6352000029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Learah Gilliam, LBSW
• Audrey Lynn Gilliatt, LMSW
• Stephanie Marie Gilliland, AGPCNP-BC
• Bethany M Gilling, FNP-BC
• Martin Ronald Gillis, DDS
• Roderick J Gillison, CPSS
• Brent Winston Gillum, D.O.
• Jeffrey Gillum, MD
• Hollie Gilmore, CTRS
• Melissa Ann Gilmore

• Psychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.