NPIMap

Organization Active NPI

Susan I Leitman, PHD, PC

  • Clinical Psychologist
  • Bloomfield Hills, MI
National Provider Identifier
1457386740
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301004071 Issued in MI
Legal business name
SUSAN I LEITMAN, PHD, PC
Practice address
36880 Woodward Ave
Suite 205
Bloomfield Hills, MI 48304-0919
Phone
(248) 258-1650
Fax
(248) 647-1572
NPI assigned
Jul 12, 2006
Last updated
Apr 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Authorized official

Name
Susan I Leitman, PHDNPI 1902017767
Title
Owner
Phone
(248) 258-1650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301004071 MI Primary

Addresses

Primary practice location

36880 Woodward Ave
Suite 205
Bloomfield Hills, MI 48304-0919

Mailing address

36880 Woodward Ave
Suite 205
Bloomfield Hills, MI 48304-0919
Phone (248) 258-1650

Other identifiers 1

IdentifierTypeStateIssuer
680F32547OtherBC/BS OF MICHIGAN

National Provider Directory

National Provider Directory

Locations

36880 Woodward Ave
Ste 205
Bloomfield Hills, MI 48304
Phone (248) 258-1650

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1457386740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36880 WOODWARD AVE",
            "address_2": "SUITE 205",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483040919",
            "telephone_number": "248-258-1650",
            "fax_number": "248-647-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36880 WOODWARD AVE",
            "address_2": "SUITE 205",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483040919",
            "telephone_number": "248-258-1650",
            "fax_number": "248-647-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN I LEITMAN, PHD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "LEITMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-258-1650",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301004071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MICHIGAN",
            "identifier": "680F32547",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.