Individual provider Active NPI

Margaret O. Brunhofer, PH.D.

  • Clinical Psychologist
  • Birmingham, MI
National Provider Identifier
1245366350
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301010016 Issued in MI
Practice address
1043 N. Glenhurst Dr
Birmingham, MI 48009-1156
Phone
(248) 644-6169
Fax
(248) 644-6679
NPI assigned
Feb 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301010016 MI Primary

Addresses

Primary practice location

1043 N. Glenhurst Dr
Birmingham, MI 48009-1156

Mailing address

1043 N. Glenhurst Dr
Birmingham, MI 48009-1156
Phone (248) 644-6169

Other identifiers 1

IdentifierTypeStateIssuer
6301010016OtherMISTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301010016MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Susan I Leitman, PHD, PC Clinical PastSince Jun 1, 2005 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1245366350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 N. GLENHURST DR",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091156",
            "telephone_number": "248-644-6169",
            "fax_number": "248-644-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 N. GLENHURST DR",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091156",
            "telephone_number": "248-644-6169",
            "fax_number": "248-644-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNHOFER",
        "first_name": "MARGARET",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-25",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301010016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "6301010016",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.