Organization Active NPI

Elena Brand, PH.D., P.L.L.C.

  • Clinical Psychologist
  • Farmington Hills, MI
National Provider Identifier
1285833293
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301008683 Issued in MI
Legal business name
ELENA BRAND, PH.D., P.L.L.C.
Practice address
36510 W 12 Mile Rd
Farmington Hills, MI 48331-3169
Phone
(248) 553-8220
Fax
(248) 553-8290
NPI assigned
Jul 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Authorized official

Name
Elena Brand, PHDNPI 1194767848
Title
Owner
Phone
(248) 553-8220

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301008683 MI Primary

Addresses

Primary practice location

36510 W 12 Mile Rd
Farmington Hills, MI 48331-3169

Mailing address

36510 W 12 Mile Rd
Farmington Hills, MI 48331-3169
Phone (248) 553-8220

Other identifiers 1

IdentifierTypeStateIssuer
680F328500OtherMIBLUE CROSS BLUE SHIELD OF

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091021000054 MI Part B Supplier - Clinic/Group Practice 7517004724 Receives reassigned benefits from 1 practitioner
Practice locations: Farmington Hills, MI

National Provider Directory

National Provider Directory

Locations

36510 W 12 Mile Rd
Farmington Hills, MI 48331
Phone (248) 254-3686

31330 Northwestern Hwy
Ste A
Farmington Hills, MI 48334
Phone (248) 553-8220

Practitioners & affiliated clinicians

Practitioners 2

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": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1285833293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36510 W 12 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313169",
            "telephone_number": "248-553-8220",
            "fax_number": "248-553-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36510 W 12 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313169",
            "telephone_number": "248-553-8220",
            "fax_number": "248-553-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELENA BRAND, PH.D., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "BRAND",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-553-8220",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301008683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "680F328500",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.