Trisha Nichole Tanis, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301019380 Issued in MI

Practice address

500 Cascade West Pkwy SE Ste 240
Grand Rapids, MI 49546-2166

Phone

(616) 591-9000

NPI assigned

Nov 30, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Grand Rapids Therapy Group Inc

  • Psychologist
  • Grand Rapids, MI
  • NPI 1295211076

  Multi-Specialty

  Medicare reassignment NPD
• Leaps and Bounds Therapy Services L.L.C.

  • Behavior Analyst
  • Howell, MI
  • NPI 1275008401

  Behavior Technician

  NPD (past)
• Northern Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Lyndonville, VT
  • NPI 1164509980

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1063016046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CASCADE WEST PKWY SE STE 240",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462166",
            "telephone_number": "616-591-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CASCADE WEST PKWY SE STE 240",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462166",
            "telephone_number": "616-591-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "238 Hoover Blvd Ste 10",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494233755",
            "country_code": "US",
            "telephone_number": "616-591-9000",
            "fax_number": "616-591-9060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANIS",
        "first_name": "TRISHA",
        "middle_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6351004500",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301019380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Jay Tanis
• Elizabeth Tanis, DPT
• Jean Tashina Tanis
• Jennifer Tanis, LMSW
• Matthew Tanis, D.O.
• John Mitchell Tanja, OTR
• Tank Consultation PLLC
• Evan Tank, DO
• Sinan Sean Tankut, M.D.
• Sarah Deshae Tanner-Morse, BCABA

• Clinical Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; 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.