Organization Active NPI

Bloomfield Counseling,P.C.

  • Psychologist
  • West Bloomfield, MI
National Provider Identifier
1063780146
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301003797 Issued in MI
Legal business name
BLOOMFIELD COUNSELING,P.C.
Practice address
5600 W Maple Rd
Suite B-208
West Bloomfield, MI 48322-3704
Phone
(248) 851-7181
Fax
(248) 851-1223
NPI assigned
Dec 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Authorized official

Name
Dr. James Howard Eisenshtadt, PH.D.NPI 1851328488
Title
President
Phone
(248) 851-7181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 6301003797 MI Primary

Addresses

Primary practice location

5600 W Maple Rd
Suite B-208
West Bloomfield, MI 48322-3704

Mailing address

5600 W Maple Rd Ste B208
West Bloomfield, MI 48322-3707
Phone (248) 851-7181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120419000499 MI Part B Supplier - Clinic/Group Practice 4981865813 Receives reassigned benefits from 1 practitioner
Practice locations: West Bloomfield, MI

National Provider Directory

National Provider Directory

Locations

5600 W Maple Rd
Ste B208
West Bloomfield, MI 48322
Phone (248) 851-7181

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323043200000",
    "number": "1063780146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 W MAPLE RD STE B208",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223707",
            "telephone_number": "248-851-7181",
            "fax_number": "248-851-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W MAPLE RD",
            "address_2": "SUITE B-208",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223704",
            "telephone_number": "248-851-7181",
            "fax_number": "248-851-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMFIELD COUNSELING,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A",
        "authorized_official_last_name": "EISENSHTADT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-851-7181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301003797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.