Individual provider Active NPI

Brianne Angel France-Ellis, PSY.D

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1720727712
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6351004475 Issued in MI
Practice address
5864 Interface Dr Ste D
Ann Arbor, MI 48103-9514
Phone
(734) 994-9466
NPI assigned
May 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6351004475 MI Primary

Addresses

Primary practice location

5864 Interface Dr Ste D
Ann Arbor, MI 48103-9514

Mailing address

3132 Thunderbird CT E
Aurora, IL 60503-5583
Phone (313) 318-0406

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

State licenses

LicenseStateTypeSpecialty
6351004475MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
CNLD Neuropsychology PC Clinical CurrentSince Jan 1, 2023 Accepting new patients
Center for Neuropsychology & Learning Clinical PastSince Jun 5, 2022 Accepting new patients

Locations

5864 Interface Dr
Ste D
Ann Arbor, MI 48103
Phone (734) 535-7446

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1720727712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 THUNDERBIRD CT E",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605035583",
            "telephone_number": "313-318-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5864 INTERFACE DR STE D",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039514",
            "telephone_number": "734-994-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANCE-ELLIS",
        "first_name": "BRIANNE",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6351004475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.