Active NPI
Michelle Sanborn, M.S., TLLP, CAC-M
- Clinical Psychologist
- Waterford, MI
National Provider Identifier
1184874760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- L1589327
- Practice address
- 709 Cedarlawn Rd
Waterford, MI 48328-4009 - Phone
- (248) 425-4166
- NPI assigned
- Sep 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | L1589327 | MI | Primary |
Addresses
Primary practice location
709 Cedarlawn Rd
Waterford, MI 48328-4009
Mailing address
709 Cedarlawn Rd
Waterford, MI 48328-4009
Phone (248) 425-4166
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1589327 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269388800000",
"number": "1184874760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 CEDARLAWN RD",
"city": "WATERFORD",
"state": "MI",
"postal_code": "483284009",
"telephone_number": "248-425-4166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 CEDARLAWN RD",
"city": "WATERFORD",
"state": "MI",
"postal_code": "483284009",
"telephone_number": "248-425-4166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANBORN",
"first_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "M.S., TLLP, CAC-M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-19",
"last_updated": "2010-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "L1589327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.