PAIGE TIEDEMAN (NPI# 1992339253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992339253 |
| Entity Type | Individual |
| Full Name | PAIGE TIEDEMAN |
| Credential | TLLP |
| Practice Address |
595 Forest Ave Plymouth MI 48170-1775 |
| Mailing Address |
8121 Jordan Rd Grand Blanc MI 48439-9623 |
| Practice Telephone | 7344465466 |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301018372 | MI | Behavioral Health & Social Service Providers |
| Street Address |
595 FOREST AVE |
| City | PLYMOUTH |
| State | MI |
| Zip Code | 48170-1775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649372608 | Laura Ann Dansel | Nurse Practitioner | 595 Forest Ave, Suite 7a, Plymouth, MI 48170-1775 | 2006-09-01 |
| 1699246652 | Rachel Lynn Noonchester | Psychologist | 595 Forest Ave, Plymouth, MI 48170-1775 | 2018-12-16 |
| 1750852570 | Tyler Pollack Incorporated | Clinic/Center | 595 Forest Ave, Plymouth, MI 48170-1775 | 2018-12-06 |
| 1538601448 | Stefanie Michelle Paquin | Psychologist | 595 Forest Ave, Suite 7a, Plymouth, MI 48170-1775 | 2016-11-09 |
| 1922451756 | Megan J Hromco Jr. | Psychologist | 595 Forest Ave, Suite 7a, Plymouth, MI 48170-1775 | 2016-07-17 |
| 1033563242 | Structure & Function | Chiropractor | 595 Forest Ave, Suite- 7b, Plymouth, MI 48170-1775 | 2016-04-14 |
| 1033546197 | Otto Albert Geiseman Iv | Chiropractor | 595 Forest Ave, Ste 7b, Plymouth, MI 48170-1777 | 2013-10-03 |
| 1598038234 | Stepping Stones Wellness Center, Pllc | Psychologist | 595 Forest Ave, Suite 7a, Plymouth, MI 48170-1775 | 2012-02-10 |
| 1285961532 | Denise L Brooks | Psychologist | 595 Forest Ave, Ste. 7a, Plymouth, MI 48170-1775 | 2009-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611734 | Brightside Medical of Michigan, P.C. | Psychiatry & Neurology | Telemedicine Services Only / No Physical Office, Telemedicine Services Only / No Physical, MI 48170 | 2020-02-18 |
| 1265075279 | Mast Enterprises | Home Health | 40800 Five Mile Rd Ste C, Plymouth, MI 48170 | 2019-10-22 |
| 1003470964 | Smiley Private Homecare LLC | Technician, Pathology | 1098 Ann Arbor Rd #249, Plymouth, MI 48170 | 2019-04-26 |
| 1275003832 | Atsalis Dental Excellence | Dentist | 690 South Main St, Plymouth, MI 48170 | 2018-11-27 |
| 1275003808 | Danielle Cefalo | Speech-Language Pathologist | 801 W. Ann Arbor Trail Suite 220, Plymouth, MI 48170 | 2018-11-27 |
| 1962987966 | Mindful Wellness Counseling, LLC | Social Worker | 9266 Northern Ave, Plymouth, MI 48170 | 2018-09-26 |
| 1972094027 | Plymouth Urgent Care Walk-in Clinic LLC | Clinic/Center | 1498 S Sheldon Rd, Plymouth, MI 48170 | 2018-05-24 |
| 1356843791 | Polaris Pharmacy Services of Michigan, LLC | Pharmacy | 9131 General Court, Plymouth, MI 48170 | 2018-03-01 |
| 1528569787 | Alcona Citizens for Health Inc | Clinic/Center | 101 S Union St Unit 101, Plymouth, MI 48170 | 2018-02-23 |
| 1073029484 | Holly Ann Haase | Technician/Technologist | 650 Church St, Plymouth, MI 48170 | 2017-12-20 |
| Find all providers in zip 48170 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790264760 | Tasha Leno | Psychologist | 595 Forest Ave Ste 7a, Plymouth, MI 48170-1777 | 2018-08-10 |
| 1679059968 | Life Improved, LLC | Psychologist | 300 Main Street, Suite 200, Plymouth, NH 03264 | 2018-07-19 |
| 1952891038 | Charles Francis Carroll | Psychologist | 17 Alvin Rd, Plymouth, MA 02360-3920 | 2018-05-15 |
| 1861914863 | Steven Schwartz | Psychologist | 12431 Howland Park Dr, Plymouth, MI 48170-2894 | 2017-07-11 |
| 1366827016 | Juliann Knochel | Psychologist | 42325 Ann Arbor Rd E, Plymouth, MI 48170-4356 | 2015-07-23 |
| 1851781959 | Stephen Mangin | Psychologist | 42245 Ann Arbor Rd E Ste 101, Plymouth, MI 48170-4311 | 2015-01-27 |
| 1649683517 | Heather M Delcourt | Psychologist | 595 Forest Ave Ste 11a, Plymouth, MI 48170-1777 | 2014-06-08 |
| 1952730723 | Amanda Michelle Henderson Bills | Psychologist | 199 N Main St Ste 200, Plymouth, MI 48170-1286 | 2013-11-02 |
| 1255779492 | Heather D Haggerty | Psychologist | 340 N Main St Ste 201, Plymouth, MI 48170-1290 | 2013-06-10 |
| 1164705471 | Ruth C. Rowbotham | Psychologist | 225 Water St Ste A115, Plymouth, MA 02360-4060 | 2011-09-22 |
| Find all providers in PLYMOUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.