Tara Kay Shepard

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6361005957 Issued in MI

Practice address

13001 23 Mile Rd Ste 103
Shelby Township, MI 48315-2767

Phone

(586) 496-4398

NPI assigned

Aug 31, 2011

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

Other identifiers 1

Other names 1

• Tara Kay Lizbinski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Premier Therapy Solutions

  • Psychologist
  • Macomb, MI
  • NPI 1174480008
  NPD Authorized official
• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1043591340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18119 RED OAKS DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442776",
            "telephone_number": "734-748-4826",
            "fax_number": "800-248-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13001 23 MILE RD STE 103",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483152767",
            "telephone_number": "586-496-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "TARA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361005957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIN #",
            "identifier": "382230613",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "LIZBINSKI",
            "middle_name": "KAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shelby Pediatric Associates and Child Lung Center PC
• Shelby Pines Cosmetic and Family Dentistry
• Shelby Township Care Center, LLC
• Shelby-Macomb Diagnostic Center, PLC
• Shelbyrx LLC
• Charles Gerard Shermetaro, O.D.
• Akash Rushikumar Sheth, M.D.
• Ronald W Shier Jr., L.P.C.
• Parisa Shifteh, MA, BCBA
• Annette M Shimkus, MSW, ACSW, LMSW

• Psychologist in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.