Sherisa Renell McDonald, MA, TLLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301018120 Issued in MI

Practice address

7310 Woodward Ave
Detroit, MI 48202-3165

Phone

(313) 896-1444

NPI assigned

Oct 21, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Assured Family Services

  • Adolescent and Children Mental Health Clinic/Center
  • Detroit, MI
  • NPI 1376057679
  NPD (past)
• Laura W Hutchison PC

  • Clinical Psychologist
  • Farmington Hills, MI
  • NPI 1770719767
  NPD (past)

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1104469303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BERKLEY AVE APT 201",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721763",
            "telephone_number": "313-646-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023165",
            "telephone_number": "313-896-1444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26105 Orchard Lake Rd Ste 207",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483344578",
            "country_code": "US",
            "telephone_number": "855-781-3974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "SHERISA",
        "middle_name": "RENELL",
        "name_prefix": "Ms.",
        "credential": "MA, TLLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin McDonald, M.D.
• Maureen Rae McDonald, CTRS
• Melori McDonald, NP
• Paige Nichole McDonald
• Payton Mariah McDonald, MD
• Colleen Marie McDowell, P.T.
• John McDowell, M.S.W.
• Kathleen Frances McDowell, R.PH.
• Jessica McElfresh, PT
• Christine Yvette McElroy, LPN

• Clinical Psychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.