Amy Zelidman, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

AMY ZELIDMAN, PLLC

Practice address

36500 W 12 Mile Rd
Farmington Hills, MI 48331-3169

Phone

(248) 514-5354

NPI assigned

Nov 7, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Amy Zelidman, PHD, LPNPI 1760622666

Title

Fully Licensed Psychologist/Owner

Phone

(248) 514-5354

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy Zelidman, PHD, LP

  • Clinical Psychologist
  • Farmington Hills, MI
  • NPI 1760622666
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1245708320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36500 W 12 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313169",
            "telephone_number": "248-514-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36500 W 12 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313169",
            "telephone_number": "248-514-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY ZELIDMAN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "ZELIDMAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "FULLY LICENSED PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "248-514-5354",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6301018956",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1",
            "identifier": "1760622666",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ama Ampomah
• Jerimiah Amundsen
• Tyler Amundson
• Amy K Pruneau LLC
• Amy L. Widenbaum, LMSW, PC
• Zachary Amy
• Jacqueline Anaele
• Nicole Anash
• Carlos Anavisca
• Amaree Anaya

• Clinical Psychologist in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.