Individual provider Active NPI

Judith A Bean, PHD

  • Clinical Neuropsychologist
  • Dearborn Heights, MI
National Provider Identifier
1306999628
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6301001417 Issued in MI
Practice address
24500 Ford Rd
Dearborn Heights, MI 48127-3182
Phone
(313) 563-0919
Fax
(313) 563-0826
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 6301001417 MI Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 6301001417 MI
Adult Development & Aging Psychologist 103TA0700X 6301001417 MI
Cognitive & Behavioral Psychologist 103TB0200X 6301001417 MI
Clinical Psychologist 103TC0700X 6301001417 MI
Counseling Psychologist 103TC1900X 6301001417 MI
Clinical Child & Adolescent Psychologist 103TC2200X 6301001417 MI
Family Psychologist 103TF0000X 6301001417 MI
Forensic Psychologist 103TF0200X 6301001417 MI
Intellectual & Developmental Disabilities Psychologist 103TM1800X 6301001417 MI
Group Psychotherapy Psychologist 103TP2701X 6301001417 MI
School Psychologist 103TS0200X 6301001417 MI

Addresses

Primary practice location

24500 Ford Rd
Dearborn Heights, MI 48127-3182

Mailing address

1937 Lone Pine Rd
Bloomfield Hills, MI 48302-2522
Phone (248) 626-9729

Other names 1

  • Dr. Judith Ann Bean Professional name

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
6301001417MIMDFamily Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1306999628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 LONE PINE RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483022522",
            "telephone_number": "248-626-9729",
            "fax_number": "248-626-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24500 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273182",
            "telephone_number": "313-563-0919",
            "fax_number": "313-563-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN",
        "first_name": "JUDITH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301001417",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MI",
            "license": "6301001417",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "BEAN",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.