Individual provider Active NPI

Ellen Barahal Taylor, PHD

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1225145246
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301003203 Issued in MI
Practice address
2300 Washtenaw Ave
Suite 203
Ann Arbor, MI 48104-4500
Phone
(734) 995-5181
Fax
(734) 995-9011
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301003203 MI Primary

Addresses

Primary practice location

2300 Washtenaw Ave
Suite 203
Ann Arbor, MI 48104-4500

Mailing address

2300 Washtenaw Ave
Suite 203
Ann Arbor, MI 48104-4500
Phone (734) 995-5181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090112000473 MI Practitioner - Clinical Psychologist 0446313852 Practice locations: Ann Arbor, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-8943
Phone (734) 995-5181

2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-9118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301003203MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225145246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WASHTENAW AVE",
            "address_2": "SUITE 203",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044500",
            "telephone_number": "734-995-5181",
            "fax_number": "734-995-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 WASHTENAW AVE",
            "address_2": "SUITE 203",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044500",
            "telephone_number": "734-995-5181",
            "fax_number": "734-995-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ELLEN",
        "middle_name": "BARAHAL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301003203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.