Individual provider Active NPI

Tonia Maria Truesdell, PHD

  • Clinical Psychologist
  • L'Anse, MI
National Provider Identifier
1902270135
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014354 Issued in MI
Practice address
118 N Main St
Lanse, MI 49946
Phone
(906) 228-8881
Fax
(906) 228-4549
NPI assigned
Nov 27, 2015
Last updated
Jun 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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 6301014354 MI Primary

Addresses

Primary practice location

118 N Main St
Lanse, MI 49946

Mailing address

102 W Washington St
Suite 106
Marquette, MI 49855-4368
Phone (906) 228-8881

Other practice location 1

102 W Washington St
Suite 106
Marquette, MI 49855-4368
Phone (906) 228-8881

Other names 1

  • Tonia Maria Wolak Former name

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
I20180323001127 MI Practitioner - Clinical Psychologist 2062774474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Psychological PCGroup PAC ID 2365662434, 4 clinicians

Practice addresses (Care Compare)

102 W Washington St
Suite 106
Marquette, MI 49855-4350
Phone (906) 228-8881

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301014354MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Access Psychological PC CurrentSince Mar 1, 2018 Accepting new patients

Locations

102 W Washington St
Ste 106
Marquette, MI 49855
Phone (906) 228-8881

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, 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": "1448582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1902270135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W WASHINGTON ST",
            "address_2": "SUITE 106",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554368",
            "telephone_number": "906-228-8881",
            "fax_number": "906-228-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N MAIN ST",
            "city": "LANSE",
            "state": "MI",
            "postal_code": "49946",
            "telephone_number": "906-228-8881",
            "fax_number": "906-228-4549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 W Washington St",
            "address_2": "Suite 106",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498554368",
            "country_code": "US",
            "telephone_number": "906-228-8881",
            "fax_number": "906-228-4549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUESDELL",
        "first_name": "TONIA",
        "middle_name": "MARIA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-27",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONIA",
            "last_name": "WOLAK",
            "middle_name": "MARIA",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in L'Anse, MI

Sources for this page

Verify at the official NPI Registry.