Tiffany Derksen, TLLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301018112 Issued in MI

Practice address

7305 Grand River Rd Ste 300
Brighton, MI 48114-7378

Phone

(734) 961-7196

Fax

(734) 961-7187

NPI assigned

Sep 26, 2019

Sex

Female

Sole proprietor

Yes

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

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.

• Neuropsychology Partners, LLC

  • Clinical Psychologist
  • Brighton, MI
  • NPI 1154849339
  NPD

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1104477652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7305 GRAND RIVER RD STE 300",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147378",
            "telephone_number": "734-961-7196",
            "fax_number": "734-961-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 GRAND RIVER RD STE 300",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147378",
            "telephone_number": "734-961-7196",
            "fax_number": "734-961-7187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKSEN",
        "first_name": "TIFFANY",
        "credential": "TLLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Demski
• Samantha J Denardo, DDS
• Ann Marie Clare Dennis
• Donna Elizabeth Depalma, LMSW
• Julia Agnes Deporre, M.D.
• Dermatology & Phototherapy Center of Brighton, PLC
• Hannah Deruyter
• Bipin Pratachandra Desai, MD
• Robert Timothy Dess, M.D.
• Leah Deter, LBS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.