Emanuel T. Vanbolden, PHD, LP, PC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6301013909 Issued in MI

Legal business name

EMANUEL T. VANBOLDEN, PHD, LP, PC

Practice address

60 Farnsworth St
Detroit, MI 48202-4060

Phone

(313) 577-2840

Fax

(313) 577-8949

NPI assigned

Oct 29, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Emanuel T. Vanbolden, PHD

Title

Owner

Phone

(248) 333-1083

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Williams

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
  • NPI 1194112052
  NPD (past)

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1013217660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42335 WOODWARD AVE",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FARNSWORTH ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482024060",
            "telephone_number": "313-577-2840",
            "fax_number": "313-577-8949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANUEL T. VANBOLDEN, PHD, LP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-29",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "VANBOLDEN",
        "authorized_official_first_name": "EMANUEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-333-1083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6301013909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammed Eltahir, M.D.
• Lynnette Marie Ely Whitfield, LLPC
• Kimberly Elyse, PH.D.
• Mohammedelhadi Anis Elhadi Elzein, MBBS
• Belief Aghoghome Emadamerho
• Aliaa Emara, M.D.
• Mohammad Emari, DO
• Embody Her LLC
• Embracing Your Comfort Care Homes
• Claudette Embry

• Community/Behavioral Health Agency in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; 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.