Individual provider Active NPI

Danielle Tipping, PSYD

  • Clinical Psychologist
  • Memphis, TN
National Provider Identifier
1801204458
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009824 Issued in IL
Practice address
2662 Hacton CV
Memphis, TN 38119-8402
Phone
(630) 923-5215
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2550 KS
Clinical Psychologist 103TC0700X 071009824 IL Primary

Addresses

Primary practice location

2662 Hacton CV
Memphis, TN 38119-8402

Mailing address

2662 Hacton CV
Memphis, TN 38119-8402
Phone (630) 923-5215

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2550KSMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Personal Growth, PLLC Clinical CurrentSince Jan 7, 2020 Accepting new patients
Four County Mental Health Center Inc Past Accepting new patients
Cowley County Mental Health Center Past Accepting new patients

Locations

640 E Saint Charles Rd
Ste 212
Carol Stream, IL 60188
Phone (630) 791-0118

Organizations & group practices 3

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": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1801204458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2662 HACTON CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381198402",
            "telephone_number": "630-923-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2662 HACTON CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381198402",
            "telephone_number": "630-923-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPING",
        "first_name": "DANIELLE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "2550",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.