Active NPI
Rebecca Nicole Thomson, PHD
- Clinical Child & Adolescent Psychologist
- Chelsea, MI
National Provider Identifier
1558848176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 6301018164
- Practice address
- 350 N Main St Ste 220
Chelsea, MI 48118-1370 - Phone
- (734) 433-5100
- NPI assigned
- Jul 26, 2018
- Last updated
- Jan 28, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 6301018164 | MI | Primary |
Addresses
Primary practice location
350 N Main St Ste 220
Chelsea, MI 48118-1370
Mailing address
350 N Main St Ste 220
Chelsea, MI 48118-1635
Phone (734) 433-5100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 30, 2024 through Jan 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301018164 | MI | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611792000000",
"number": "1558848176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 N MAIN ST STE 220",
"city": "CHELSEA",
"state": "MI",
"postal_code": "481181635",
"telephone_number": "734-433-5100",
"fax_number": "734-433-5101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 N MAIN ST STE 220",
"city": "CHELSEA",
"state": "MI",
"postal_code": "481181370",
"telephone_number": "734-433-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMSON",
"first_name": "REBECCA",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-26",
"last_updated": "2021-01-28",
"certification_date": "2021-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MI",
"license": "6301018164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chelsea, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.