Individual provider Active NPI

Laura Bryn Sanders, PSYD, LLP

  • Clinical Psychologist
  • Bloomfield Hills, MI
National Provider Identifier
1679722243
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301015227 Issued in MI
Practice address
3910 Telegraph Rd Ste 202
Bloomfield Hills, MI 48302-1461
Phone
(248) 342-7927
NPI assigned
Sep 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301015227 MI Primary

Addresses

Primary practice location

3910 Telegraph Rd Ste 202
Bloomfield Hills, MI 48302-1461

Mailing address

3910 Telegraph Rd Ste 202
Bloomfield Hills, MI 48302-1461
Phone (248) 342-7927

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

State licenses

LicenseStateTypeSpecialty
6301015227MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1679722243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 TELEGRAPH RD STE 202",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021461",
            "telephone_number": "248-342-7927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 TELEGRAPH RD STE 202",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021461",
            "telephone_number": "248-342-7927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "LAURA",
        "middle_name": "BRYN",
        "credential": "PSYD, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-18",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015227",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 27, 2015; 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.