Individual provider Active NPI

Tessa R Passarelli, MS

  • Clinical Psychologist
  • Ypsilanti, MI
National Provider Identifier
1720765019
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6362009750 Issued in MI
Practice address
4870 W Clark Rd Ste 106
Ypsilanti, MI 48197-1104
Phone
(734) 961-7196
NPI assigned
Jun 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 6362009750 MI Primary

Addresses

Primary practice location

4870 W Clark Rd Ste 106
Ypsilanti, MI 48197-1104

Mailing address

33725 Harlowshire St
Farmington Hills, MI 48335-5347
Phone (248) 914-1269

Other practice location 1

33725 Harlowshire St
Farmington Hills, MI 48335-5347
Phone (248) 914-1269

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 Science

State licenses

LicenseStateTypeSpecialty
6362009750MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology Partners, LLC Clinical CurrentSince Jul 2, 2023 Accepting new patients

Locations

4870 W Clark Rd
Ste 106
Ypsilanti, MI 48197
Phone (734) 961-7196

Organizations & group practices 1

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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1720765019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33725 HARLOWSHIRE ST",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483355347",
            "telephone_number": "248-914-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4870 W CLARK RD STE 106",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971104",
            "telephone_number": "734-961-7196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33725 Harlowshire St",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483355347",
            "country_code": "US",
            "telephone_number": "248-914-1269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASSARELLI",
        "first_name": "TESSA",
        "middle_name": "R",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362009750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.