Active NPI
Janelle Marie Tidemann, LCP
- Clinical Child & Adolescent Psychologist
- Topeka, KS
National Provider Identifier
1437344694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- LCP 272
- Practice address
- 5847 SW 29TH St
Topeka, KS 66614-2462 - Phone
- (785) 273-7292
- NPI assigned
- Sep 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | LCP 272 | KS | Primary |
Addresses
Primary practice location
5847 SW 29TH St
Topeka, KS 66614-2462
Mailing address
5847 SW 29TH St
Topeka, KS 66614-2462
Phone (785) 273-7292
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCP 272 | KS | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575417600000",
"number": "1437344694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5847 SW 29TH ST",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666142462",
"telephone_number": "785-273-7292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5847 SW 29TH ST",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666142462",
"telephone_number": "785-273-7292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDEMANN",
"first_name": "JANELLE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "LCP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-11",
"last_updated": "2019-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "KS",
"license": "LCP 272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Topeka, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.