Individual provider Active NPI

Elizabeth Cornelia Derooy, PH.D.

  • Clinical Psychologist
  • Roseville, MI
National Provider Identifier
1477603397
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301009802 Issued in MI
Practice address
25869 Kelly Rd
Suite a
Roseville, MI 48066-4997
Phone
(586) 773-6020
Fax
(586) 773-6093
NPI assigned
Jan 11, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301009802 MI
Clinical Psychologist 103TC0700X 6301009802 MI Primary
Counseling Psychologist 103TC1900X 6301009802 MI

Addresses

Primary practice location

25869 Kelly Rd
Suite a
Roseville, MI 48066-4997

Mailing address

25869 Kelly Rd
Suite a
Roseville, MI 48066-4997
Phone (586) 773-6020

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

LicenseStateTypeSpecialty
6301009802MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Biological Psychiatry Center, P.C. Clinical PastSince Oct 1, 2004 Accepting new patients
Biological Psychiatry Center, PC Clinical Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1477603397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25869 KELLY RD",
            "address_2": "SUITE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664997",
            "telephone_number": "586-773-6020",
            "fax_number": "586-773-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25869 KELLY RD",
            "address_2": "SUITE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664997",
            "telephone_number": "586-773-6020",
            "fax_number": "586-773-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROOY",
        "first_name": "ELIZABETH",
        "middle_name": "CORNELIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301009802",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301009802",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301009802",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.