Active NPI
Barbara Cornblath, PH.D
- Clinical Psychologist
- Ann Arbor, MI
National Provider Identifier
1689843468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301008485
- Practice address
- 117 N 1St St Ste 103
Ann Arbor, MI 48104-1354 - Phone
- (734) 646-2683
- NPI assigned
- Feb 26, 2008
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301008485 | MI | Primary |
Addresses
Primary practice location
117 N 1St St Ste 103
Ann Arbor, MI 48104-1354
Mailing address
117 N 1St St Ste 103
Ann Arbor, MI 48104-1354
Phone (734) 646-2683
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008485 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446681600000",
"number": "1689843468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 N 1ST ST STE 103",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481041354",
"telephone_number": "734-646-2683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 N 1ST ST STE 103",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481041354",
"telephone_number": "734-646-2683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNBLATH",
"first_name": "BARBARA",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-26",
"last_updated": "2015-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301008485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.