Individual provider Active NPI

Robin Renae Barris, TLLP, MA

  • Psychologist
  • Muskegon, MI
National Provider Identifier
1285774422
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301009658 Issued in MI
Practice address
3370 Glade Street
Muskegon, MI 49444-2278
Phone
(231) 737-1213
Fax
(231) 737-1218
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301009658 MI Primary
Psychologist 103T00000X

Addresses

Primary practice location

3370 Glade Street
Muskegon, MI 49444-2278

Mailing address

3370 Glade St
Muskegon, MI 49444-2778
Phone (231) 737-1213

Other identifiers 2

IdentifierTypeStateIssuer
P108978420OtherMIBCBS
11659660OtherMICAQH

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 Arts

State licenses

LicenseStateTypeSpecialty
6301009658MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Jansen-Yee PSYD & Associates PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1285774422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3370 GLADE ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442778",
            "telephone_number": "231-737-1213",
            "fax_number": "231-737-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3370 GLADE STREET",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442278",
            "telephone_number": "231-737-1213",
            "fax_number": "231-737-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRIS",
        "first_name": "ROBIN",
        "middle_name": "RENAE",
        "name_prefix": "Mrs.",
        "credential": "TLLP, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301009658",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P108978420",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11659660",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.