Individual provider Active NPI

Judy Leigh Atkins, MA,TLLP,CAAC

  • Clinical Psychologist
  • Royal Oak, MI
National Provider Identifier
1578738431
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301013703 Issued in MI
Practice address
26862 Woodward Ave
Suite 102
Royal Oak, MI 48067-0957
Phone
(248) 398-0740
Fax
(248) 398-9456
NPI assigned
Apr 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301013703 MI Primary

Addresses

Primary practice location

26862 Woodward Ave
Suite 102
Royal Oak, MI 48067-0957

Mailing address

26862 Woodward Ave
Suite 102
Royal Oak, MI 48067-0957
Phone (248) 398-0740

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6301013703MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1578738431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26862 WOODWARD AVE",
            "address_2": "SUITE 102",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480670957",
            "telephone_number": "248-398-0740",
            "fax_number": "248-398-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26862 WOODWARD AVE",
            "address_2": "SUITE 102",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480670957",
            "telephone_number": "248-398-0740",
            "fax_number": "248-398-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINS",
        "first_name": "JUDY",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "MA,TLLP,CAAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.