Jonathan Lawrence Lundblad, MA
Individual provider Active NPI Psychologist · Bingham Farms, MI
NPI 1396519005 · NPPES record last updated Nov 12, 2025
Key facts
- NPI
- 1396519005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 6362009597 (MI)
- Practice address
- 30150 Telegraph Rd Ste 245
Bingham Farms, MI 48025-4521 - Phone
- (800) 693-1916
- NPI assigned
- Nov 13, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6362009597 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Naberhaus Therapy, Inc. | Past | Accepting new patients | |
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6362009597 | MI | Yes |
Addresses
Primary practice location
30150 Telegraph Rd Ste 245
Bingham Farms, MI 48025-4521
Mailing address
30150 Telegraph Rd Ste 245
Bingham Farms, MI 48025-4521
Phone (313) 889-4321
Other providers in Bingham Farms, MI
- Patricia Anne Lugger
- Luke OBGYN Care PC
- Josephine Lulgjuraj
- Nicolette Lulgjuraj
- Christopher Robert Lumley
- Tyler Lusczki
- Andrey Lutskovsky
- Lindsey Lyda
- Ashley Elizabeth Lynch
- Brigid Grace Lynch
All providers in Bingham Farms, MI · Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.