Provider Demographics
NPI:1437030509
Name:JAMIESON, CAITLYN ANNE (TLLP)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ANNE
Last Name:JAMIESON
Suffix:
Gender:F
Credentials:TLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15651 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2705
Mailing Address - Country:US
Mailing Address - Phone:313-212-4819
Mailing Address - Fax:
Practice Address - Street 1:31478 INDUSTRIAL RD STE 300
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1840
Practice Address - Country:US
Practice Address - Phone:734-245-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362010264103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical