Individual provider Active NPI

Angelena Schramm, TLLP

  • Psychologist
  • Birmingham, MI
National Provider Identifier
1376264655
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6362009593 Issued in MI
Practice address
912 S Old Woodward Ave Ste 200
Birmingham, MI 48009-6721
Phone
(248) 537-2639
NPI assigned
Sep 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6362009593 MI Primary

Addresses

Primary practice location

912 S Old Woodward Ave Ste 200
Birmingham, MI 48009-6721

Mailing address

657 Pine Tree CT
Walled Lake, MI 48390-3748
Phone (616) 422-8433

Other practice location 1

657 Pine Tree Ct
Walled Lake, MI 48390-3748
Phone (616) 422-8433

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

State licenses

LicenseStateTypeSpecialty
6362009593MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mybody, PLLC CurrentSince Sep 11, 2022 Accepting new patients
Dr. Lainie Epstein PLLC Psychologist PastSince Jul 1, 2019 Accepting new patients

Locations

912 S Old Woodward Ave
Ste 200
Birmingham, MI 48009
Phone (248) 537-2639

Organizations & group practices 2

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": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1376264655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 PINE TREE CT",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903748",
            "telephone_number": "616-422-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S OLD WOODWARD AVE STE 200",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096721",
            "telephone_number": "248-537-2639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "657 Pine Tree Ct",
            "address_purpose": "LOCATION",
            "city": "Walled Lake",
            "state": "MI",
            "postal_code": "483903748",
            "country_code": "US",
            "telephone_number": "616-422-8433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHRAMM",
        "first_name": "ANGELENA",
        "credential": "TLLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6362009593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.