George Lawrence Vanderbossche, MA, LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301010771 Issued in MI

Practice address

41000 Woodward Ave Ste 350
Bloomfield Hills, MI 48304-5092

Phone

(313) 316-8962

NPI assigned

Jul 17, 2006

Last updated

May 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gvanderbossche1156367@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Creative Dimension Psychotherapy PLLC

  • Psychologist
  • Bloomfield Hills, MI
  • NPI 1235991241
  NPD Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1033137054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25657 COLGATE ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481251548",
            "telephone_number": "313-316-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41000 WOODWARD AVE STE 350",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045092",
            "telephone_number": "313-316-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBOSSCHE",
        "first_name": "GEORGE",
        "middle_name": "LAWRENCE",
        "credential": "MA, LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301010771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Lynn Van Wormer, MA, LLP
• Emanuel T Vanbolden, PHD LP
• Katherine Aileen Vance, LMSW
• Agnes E Vandeputte, CRNA
• Victoria Lyn Vander Velde, PA
• Lori Vansloten
• Jared Vanzant, DPT
• Thomas G Varbedian, M.D.
• Vaughan Center for Personal Growth and Development
• Pamela Marie Vaughan, LLP

• Psychologist in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.