Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Alicia Ellen Tisdale, PHD

Individual provider Psychologist · NPI 1083622914

Dr. Alicia Ellen Tisdale, PHD is a Clinical Psychologist in West Bloomfield, Michigan. Qualified in 1988, 38 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
38
Licensed in
MI
In the registry since
2006
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

5101 Willow Pond Dr
West Bloomfield, MI 48323
Phone: (248) 974-1783
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 6301003007 (MI)
Clinical Psychologist Taxonomy 103TC0700X · Licence 6301003007 (MI)

Record details

NPI number1083622914
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedAugust 4, 2006
Last updated in NPPESOctober 30, 2025
Certification dateOctober 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in West Bloomfield