Active NPI
Nancy Blieden
- Psychoanalysis Psychologist
- Southfield, MI
National Provider Identifier
1760682900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalysis Psychologist
- License
- 6301007569
- Practice address
- 29260 Franklin Rd
Suite 105
Southfield, MI 48034-1161 - Phone
- (248) 352-5999
- Fax
- (248) 538-8604
- NPI assigned
- Jul 24, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301007569 | MI | |
| Psychoanalysis Psychologist | 103TP0814X | 6301007569 | MI | Primary |
Addresses
Primary practice location
29260 Franklin Rd
Suite 105
Southfield, MI 48034-1161
Mailing address
29260 Franklin Rd
Suite 105
Southfield, MI 48034-1161
Phone (248) 352-5999
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301007569 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1760682900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29260 FRANKLIN RD",
"address_2": "SUITE 105",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480341161",
"telephone_number": "248-352-5999",
"fax_number": "248-538-8604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29260 FRANKLIN RD",
"address_2": "SUITE 105",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480341161",
"telephone_number": "248-352-5999",
"fax_number": "248-538-8604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLIEDEN",
"first_name": "NANCY",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-24",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301007569",
"primary": false
},
{
"code": "103TP0814X",
"taxonomy_group": "",
"desc": "Psychologist, Psychoanalysis",
"state": "MI",
"license": "6301007569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.