Tieshau Middlebrooks, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ0089500 Issued in NJ

Practice address

1200 S Church St Ste 20
Mount Laurel, NJ 08054-2936

Phone

(609) 937-3491

Fax

(609) 853-0221

NPI assigned

Nov 10, 2006

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 NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Neurocognitive Institute LLCGroup PAC ID 6204095185, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• The Neurocognitive Institute LLC

  • Clinical Neuropsychologist
  • Mount Arlington, NJ
  • NPI 1841573375

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Infinite Medical PC

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1407483175

  NJ

  Medicare reassignment NPD
• Branches of Hope

  • Psychiatry Physician
  • Mount Laurel, NJ
  • NPI 1285217604
  NPD Authorized official

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1063583375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S CHURCH ST STE 20",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542936",
            "telephone_number": "609-239-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CHURCH ST STE 20",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542936",
            "telephone_number": "609-937-3491",
            "fax_number": "609-853-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLEBROOKS",
        "first_name": "TIESHAU",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ0089500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvatore Montana Messina, DO
• Meredith Danziger Messinger, LPC
• Sarah Messink
• Jonathon Metz, BCBA
• Kyle Nicholas Miceli, MSW, LCSW, CSSW,
• Arianna N. Mihalakakos, AUD
• Aliana A Miles
• Mill Pharmacy,Inc
• Jessica Miller
• Patricia J. Miller, LPC

• Psychiatric/Mental Health Nurse Practitioner in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.