Individual provider Active NPI

Sarah Pieciak, TLLP

  • Psychologist
  • West Bloomfield, MI
National Provider Identifier
1962149096
Registry record updated May 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6362009524 Issued in MI
Practice address
5777 W Maple Rd Ste 145
West Bloomfield, MI 48322-4471
Phone
(248) 455-6619
NPI assigned
May 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6362009524 MI Primary

Addresses

Primary practice location

5777 W Maple Rd Ste 145
West Bloomfield, MI 48322-4471

Mailing address

6845 Granger Dr
Troy, MI 48098-6905
Phone (586) 854-4696

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

State licenses

LicenseStateTypeSpecialty
6362009524MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Pine, Inc. Psychologist PastSince May 1, 2018 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": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653177600000",
    "number": "1962149096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6845 GRANGER DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986905",
            "telephone_number": "586-854-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 W MAPLE RD STE 145",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224471",
            "telephone_number": "248-455-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIECIAK",
        "first_name": "SARAH",
        "credential": "TLLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-22",
        "certification_date": "2022-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6362009524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2022; 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.