NPIMap

Organization Active NPI

Noemi Ebenstein

  • Clinical Psychologist
  • Southfield, MI
National Provider Identifier
1609010867
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301002033 Issued in MI
Legal business name
NOEMI EBENSTEIN
Practice address
30161 Southfield Rd
Suite 105
Southfield, MI 48076-1435
Phone
(248) 644-7390
NPI assigned
Apr 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Authorized official

Name
Dr. Noemi Ebenstein, PHDNPI 1073667531
Title
President
Phone
(248) 644-7390

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 6301002033 MI Primary

Addresses

Primary practice location

30161 Southfield Rd
Suite 105
Southfield, MI 48076-1435

Mailing address

30161 Southfield Rd
Suite 105
Southfield, MI 48076-1435
Phone (248) 644-7390

Other identifiers 1

IdentifierTypeStateIssuer
6301002033OtherMILICENSE NUMBER

Other names 1

  • Noemi Ebenstein PHD PC Doing business as

National Provider Directory

National Provider Directory

Locations

30161 Southfield Rd
Ste 105
Southfield, MI 48076
Phone (248) 644-7390

Practitioners & affiliated clinicians

Practitioners 1

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": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241049600000",
    "number": "1609010867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30161 SOUTHFIELD RD",
            "address_2": "SUITE 105",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761435",
            "telephone_number": "248-644-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30161 SOUTHFIELD RD",
            "address_2": "SUITE 105",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761435",
            "telephone_number": "248-644-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOEMI EBENSTEIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-30",
        "last_updated": "2009-04-30",
        "status": "A",
        "authorized_official_last_name": "EBENSTEIN",
        "authorized_official_first_name": "NOEMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-644-7390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301002033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "6301002033",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Noemi Ebenstein PHD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.