Andrea Leenette Taylor

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301019134 Issued in MI

Practice address

24166 Trafalgar CT
Novi, MI 48374-3667

Phone

(248) 497-1001

NPI assigned

Oct 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Looking for a Miracle, LLC

  • Mental Health Counselor
  • Novi, MI
  • NPI 1700496197

  Clinical

  Medicare reassignment NPD Authorized official
• Focus Therapy Clinic

  • Marriage & Family Therapist
  • Southfield, MI
  • NPI 1053930180
  NPD (past)

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1861968638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24166 TRAFALGAR CT",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483743667",
            "telephone_number": "248-497-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24166 TRAFALGAR CT",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483743667",
            "telephone_number": "248-497-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ANDREA",
        "middle_name": "LEENETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401009648",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301019134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasamin Tavallaei
• Ashlee Tavenner
• Jeremiah Taveras
• Michelle Deanna Taverner, LMSW
• Ellinor Taylor-Stoval
• Angelena Renee Taylor, M.ED
• Angelo Taylor
• Ashton Kyleigh Taylor, LMSW
• Brandy Taylor
• Brianna Taylor

• Clinical Psychologist in Novi, MI
• Providers in Novi, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.