Tiffany Marie Shader, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

P.08452 Issued in OH

Practice address

4100 Horizons Dr.
Ste 202, Office 203
Columbus, OH 43220

Phone

(614) 355-8160

Fax

(614) 355-8180

NPI assigned

Aug 25, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• C.a.a.T. Psychological Services Incorporated

  • Psychologist
  • Yorba Linda, CA
  • NPI 1346077450
  NPD Authorized official

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1083014302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 HORIZONS DR.",
            "address_2": "STE 202, OFFICE 203",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432205280",
            "telephone_number": "714-357-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 HORIZONS DR.",
            "address_2": "STE 202, OFFICE 203",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43220",
            "telephone_number": "614-355-8160",
            "fax_number": "614-355-8180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19111 Villa Park Rd.",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "92869",
            "country_code": "US",
            "telephone_number": "657-234-2206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHADER",
        "first_name": "TIFFANY",
        "middle_name": "MARIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "32997",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.08452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ali Shadchehr
• Ali J. Shadchehr, D.O
• Leslie Shade, RPH
• Melinda Christine Shade, BSW, LSW
• Tria Ann Shadeed, NURSE PRACTITIONER N
• Ashton Lavonda Shaffer, CDCA
• Austin James Shaffer, DO
• Betsy L.E. Shaffer, APRN-CNP
• Danielle R Shaffer
• Elliot Shaffer, SW-T

• Psychologist in Columbus, OH
• Providers in Columbus, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.