Organization Active NPI

Joanna Bielenin PC

  • Clinical Psychologist
  • Ypsilanti, MI
National Provider Identifier
1790007136
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301005020 Issued in MI
Legal business name
JOANNA BIELENIN PC
Practice address
300 N Huron St
Ypsilanti, MI 48197-2842
Phone
(734) 476-7282
NPI assigned
Feb 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Authorized official

Name
Joanna Bielenin, PHD
Title
Owner
Phone
(734) 476-7282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301005020 MI Primary

Addresses

Primary practice location

300 N Huron St
Ypsilanti, MI 48197-2842

Mailing address

300 N Huron St
Ypsilanti, MI 48197-2842
Phone (734) 476-7282

Other identifiers 1

IdentifierTypeStateIssuer
0H11757OtherMIBCBS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1790007136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N HURON ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972842",
            "telephone_number": "734-476-7282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N HURON ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972842",
            "telephone_number": "734-476-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNA BIELENIN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-26",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "BIELENIN",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-476-7282",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301005020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0H11757",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.