Active NPI
Elona Braho, MA LLP CAADC
- Psychologist
- Pontiac, MI
National Provider Identifier
1386943090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301014620
- Practice address
- 1685 Baldwin Ave
Pontiac, MI 48340-1115 - Phone
- (248) 706-3450
- NPI assigned
- Mar 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301014620 | MI | Primary |
Addresses
Primary practice location
1685 Baldwin Ave
Pontiac, MI 48340-1115
Mailing address
1685 Baldwin Ave
Pontiac, MI 48340-1115
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301014620 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Easterseals Morc Health Care, Inc. | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Easter Seals-Michigan, Inc
- Psychiatry Physician
- Auburn Hills, MI
- NPI 1376526616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474934400000",
"number": "1386943090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1685 BALDWIN AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483401115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1685 BALDWIN AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483401115",
"telephone_number": "248-706-3450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAHO",
"first_name": "ELONA",
"credential": "MA LLP CAADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-21",
"last_updated": "2016-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301014620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.