Tifini a. Roberts, Psy.D., LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2007015271 Issued in MO

Legal business name

TIFINI A. ROBERTS, PSY.D., LLC

Practice address

2146 W Chesterfield Blvd
Ste. E202
Springfield, MO 65807-8650

Phone

(417) 886-8540

Fax

(417) 886-8560

NPI assigned

Mar 18, 2008

Last updated

Feb 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tifini Autumn Roberts, PSY.D.NPI 1093904534

Title

Psychologist

Phone

(417) 886-8540

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tifini Autumn Roberts, PSY.D.

  • Clinical Psychologist
  • Springfield, MO
  • NPI 1093904534
  Authorized official Same address or phone

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1992976955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2146 W CHESTERFIELD BLVD",
            "address_2": "STE. E202",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658078650",
            "telephone_number": "417-886-8540",
            "fax_number": "417-886-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2146 W CHESTERFIELD BLVD",
            "address_2": "STE. E202",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658078650",
            "telephone_number": "417-886-8540",
            "fax_number": "417-886-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFINI A. ROBERTS, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "TIFINI",
        "authorized_official_middle_name": "AUTUMN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "417-886-8540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2007015271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497543900",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ticknor Counseling
• Brenda L Ticknor, LIMHP, LMHC, SADC, L
• Kristi M. Tidwell
• Juliah C Tiedemann, M.D.
• Melissa Ree Tiffany, MS, LPC
• Betty Gail Tilleman, ATC, LAT
• Bryce Tilley
• David Paul Tillman, D.O.
• Julian Scott Tillman, MA, LPC
• Kerri Elise Tillman, MS PLPC NCC

• Clinical Psychologist in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.