Matthew Maclellan, TLLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301016821 Issued in MI

Practice address

1800 W Big Beaver Rd
Suite 150
Troy, MI 48084-3545

Phone

(248) 918-5600

NPI assigned

Feb 16, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mindbloom Psychological Services

  • Psychologist
  • Shelby Township, MI
  • NPI 1871228890
  NPD Authorized official
• Macomb Oakland Regional Center Inc.

  • Community/Behavioral Health Agency
  • Auburn Hills, MI
  • NPI 1023199965
  NPD (past)

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1487045217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W BIG BEAVER RD",
            "address_2": "SUITE 150",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W BIG BEAVER RD",
            "address_2": "SUITE 150",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843545",
            "telephone_number": "248-918-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLELLAN",
        "first_name": "MATTHEW",
        "credential": "TLLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-16",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301016821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alleda E Mack, MD
• Brandon Edwin Mackenzie, PA
• James C Mackenzie, MD
• Denise Frances Mackey, MD
• Morgan Macklem
• Brittany Maclennan, D.C.
• Leah C Macmartin, P.A.
• Julie Christine Macpherson, DO
• Shailender Venkatratnam Madani, MD
• Kaitlin Maday

• Psychologist in Troy, MI
• Providers in Troy, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.