Active NPI
Andrea T Anderson, PH.D.
- Clinical Psychologist
- Farmington Hills, MI
National Provider Identifier
1356475743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301014329
- Practice address
- 28555 Orchard Lake Rd Ste 230
Farmington Hills, MI 48334-2974 - Phone
- (248) 509-4575
- NPI assigned
- Mar 15, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | RPS2005242 | CA | |
| Clinical Psychologist | 103TC0700X | 6301014329 | MI | Primary |
Addresses
Primary practice location
28555 Orchard Lake Rd Ste 230
Farmington Hills, MI 48334-2974
Mailing address
28555 Orchard Lake Rd Ste 230
Farmington Hills, MI 48334-2974
Phone (248) 509-4575
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPS2005242 | CA | MD | Clinical Psychologist |
| 6301014329 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616025600000",
"number": "1356475743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28555 ORCHARD LAKE RD STE 230",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483342974",
"telephone_number": "248-509-4575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28555 ORCHARD LAKE RD STE 230",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483342974",
"telephone_number": "248-509-4575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ANDREA",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2021-03-18",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "RPS2005242",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301014329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.