Individual provider Active NPI

Danielle Lynn Taylor, PHD

  • Clinical Psychologist
  • Livonia, MI
National Provider Identifier
1831629971
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301018839 Issued in MI
Practice address
16836 Newburgh Rd # 27
Livonia, MI 48154-1600
Phone
(734) 464-4220
Fax
(734) 464-5885
NPI assigned
Jun 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1734 SC
Clinical Psychologist 103TC0700X 6301018839 MI Primary

Addresses

Primary practice location

16836 Newburgh Rd # 27
Livonia, MI 48154-1600

Mailing address

400 Mack Ave
Detroit, MI 48201-2136

Other practice location 1

3901 Chrysler Dr Ste 3B
Detroit, MI 48201-2167
Phone (313) 577-1396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230418001766 MI Practitioner - Clinical Psychologist 4688049992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

16836 Newburgh Rd
Suite 27
Livonia, MI 48154-1600
Phone (734) 464-4220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301018839MIMDClinical Psychologist
1734SCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group CurrentSince Mar 14, 2023 Accepting new patients
Indian Health Care Resource Center PastSince Mar 24, 2003 Accepting new patients
Indian Health Care Resource Center of Tulsa, Inc. Past Accepting new patients
University Physician Group PastSince Mar 14, 2023 Accepting new patients

Locations

400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006

3901 Chrysler Dr
Ste 3B
Detroit, MI 48201
Phone (313) 577-1396

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

16836 Newburgh Rd
Ste 27
Livonia, MI 48154

16836 Newburgh Rd
#27
Livonia, MI 48154
Phone (734) 464-4220

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Interoperability endpoints

  • Direct secure messaging: danielle.taylor.1@19711.direct.athenahealth.com

Organizations & group practices 4

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1831629971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16836 NEWBURGH RD # 27",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541600",
            "telephone_number": "734-464-4220",
            "fax_number": "734-464-5885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Chrysler Dr Ste 3B",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012167",
            "country_code": "US",
            "telephone_number": "313-577-1396",
            "fax_number": "313-577-1419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DANIELLE",
        "middle_name": "LYNN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1734",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.