Individual provider Active NPI

Kristine Marie Vazzano, PHD

  • Clinical Psychologist
  • Bloomfield Hills, MI
National Provider Identifier
1902932403
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014012 Issued in MI
Practice address
3910 Telegraph Rd
Suite 202
Bloomfield Hills, MI 48302-1420
Phone
(248) 686-0346
Fax
(248) 686-0344
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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 6301014012 MI Primary

Addresses

Primary practice location

3910 Telegraph Rd
Suite 202
Bloomfield Hills, MI 48302-1420

Mailing address

3910 Telegraph Rd
Suite 202
Bloomfield Hills, MI 48302-1420
Phone (248) 686-0346

Other names 1

  • Dr. Kristine Marie Tippen Former name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301014012MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Helfman and Associates, P.C. Clinical PastSince Dec 11, 2011 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1902932403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 TELEGRAPH RD",
            "address_2": "SUITE 202",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021420",
            "telephone_number": "248-686-0346",
            "fax_number": "248-686-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 TELEGRAPH RD",
            "address_2": "SUITE 202",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021420",
            "telephone_number": "248-686-0346",
            "fax_number": "248-686-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZZANO",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "TIPPEN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.