Active NPI
Rachel A Tannenbaum, LMHC
- Psychologist
- Ypsilanti, MI
National Provider Identifier
1235245846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6361004572
- Practice address
- 5401 McAuley Drive
Ypsilanti, MI 48197 - Phone
- (734) 786-2300
- Fax
- (734) 786-4915
- NPI assigned
- Aug 23, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6361004572 | MI | Primary |
Addresses
Primary practice location
5401 McAuley Drive
Ypsilanti, MI 48197
Mailing address
24 Frank Lloyd Wright Drive
Ste J2000
Ann Arbor, MI 48105
Phone (734) 747-6766
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2220002001 | Other | MA | BCBS SA |
| 1306421 | Medicaid | MA | |
| 1308785 | Other | MA | MCD MH |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710892800000",
"number": "1235245846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 FRANK LLOYD WRIGHT DRIVE",
"address_2": "STE J2000",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48105",
"telephone_number": "734-747-6766",
"fax_number": "734-222-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 MCAULEY DRIVE",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "48197",
"telephone_number": "734-786-2300",
"fax_number": "734-786-4915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNENBAUM",
"first_name": "RACHEL",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2024-03-20",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6361004572",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS SA",
"identifier": "2220002001",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306421",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCD MH",
"identifier": "1308785",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.