Individual provider Active NPI

Siedah Ladonna Spencer-Ardis, MA, LMFT

  • Marriage & Family Therapist
  • Southfield, MI
National Provider Identifier
1093294860
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4101006933 Issued in MI
Practice address
26555 Evergreen Rd Ste 870
Southfield, MI 48076-4239
Phone
(248) 430-0594
Fax
(800) 868-0294
NPI assigned
Aug 12, 2018
Last updated
Jan 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4101006811 MI
Marriage & Family Therapist 106H00000X 4101006933 MI Primary

Addresses

Primary practice location

26555 Evergreen Rd Ste 870
Southfield, MI 48076-4239

Mailing address

26555 Evergreen Rd Ste 870
Southfield, MI 48076-4239
Phone (248) 430-0594

Other practice location 1

1000 S Old Woodward Ave Ste 108
Birmingham, MI 48009-6729
Phone (248) 470-4989

Other practice location 2

330 Town Center Dr Ste 328
Dearborn, MI 48126-2795
Phone (248) 430-0594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4101006811MIMDMarriage & Family Therapist
4101006933MIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Therapy Clinic Marriage & Family Therapist CurrentSince Apr 1, 2020 Accepting new patients

Locations

1000 S Old Woodward Ave
Ste 108
Birmingham, MI 48009
Phone (248) 258-9189

330 Town Center Dr
Ste 328
Dearborn, MI 48126
Phone (248) 430-0594

26555 Evergreen Rd
Ste 870
Southfield, MI 48076
Phone (248) 430-0594

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1534032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1093294860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26555 EVERGREEN RD STE 870",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764239",
            "telephone_number": "248-430-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26555 EVERGREEN RD STE 870",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764239",
            "telephone_number": "248-430-0594",
            "fax_number": "800-868-0294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 S Old Woodward Ave Ste 108",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "MI",
            "postal_code": "480096729",
            "country_code": "US",
            "telephone_number": "248-470-4989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Town Center Dr Ste 328",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481262795",
            "country_code": "US",
            "telephone_number": "248-430-0594",
            "fax_number": "800-868-0294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER-ARDIS",
        "first_name": "SIEDAH",
        "middle_name": "LADONNA",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-12",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006811",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.