Eric S Blumberg, PH.D., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401006393 Issued in MI

Practice address

12010 Linwood St
Detroit, MI 48206-1108

Phone

(313) 867-1090

Fax

(313) 867-0706

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wentworth and Associates PCGroup PAC ID 9537140819, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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

• Wentworth and Associates PC

  • Psychologist
  • Utica, MI
  • NPI 1306827191
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083821946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 LEROY ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482203114",
            "telephone_number": "313-867-1090",
            "fax_number": "313-867-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12010 LINWOOD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061108",
            "telephone_number": "313-867-1090",
            "fax_number": "313-867-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMBERG",
        "first_name": "ERIC",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401006393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Water Pain Specialists PC
• Kenneth Deon Blue, CADCM
• Bluesky Homecare Services LLC
• Joseph Bluhm
• Natalie Blum, D.O.
• Robert Allan Blumberg, DO
• Mark L. Blumenkehl, M.D.
• Collin Randall Blundell
• Martin H Bluth, M.D.
• Dionne Josepha Blyden, M.D.

• Professional Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.