Individual provider Active NPI

Tiffany Brown, PSYD, CAMS-II

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1750893376
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071011395 Issued in IL
Practice address
9522 S Halsted St
Chicago, IL 60628-1028
Phone
(773) 595-5794
NPI assigned
Nov 5, 2017
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Forensic Psychologist 103TF0200X
Clinical Psychologist 103TC0700X 071011395 IL Primary

Addresses

Primary practice location

9522 S Halsted St
Chicago, IL 60628-1028

Mailing address

9522 S Halsted St
Chicago, IL 60628-1028
Phone (773) 595-5794

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
071011395ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Domestic & Family Counseling Clinic Mental Health CurrentSince Sep 25, 2019 Accepting new patients
Family First Domestic & Family Counseling Clinic CurrentSince Sep 25, 2019 Accepting new patients

Locations

8543 S Stony Island Ave
Chicago, IL 60617
Phone (773) 531-9571

9522 S Halsted St
Chicago, IL 60628
Phone (708) 462-2720

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1750893376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9522 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281028",
            "telephone_number": "773-595-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9522 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281028",
            "telephone_number": "773-595-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "PSYD, CAMS-II",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-05",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071011395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.