Active NPI
Benora Gladstone, MA,LLP
- Psychologist
- Bloomfield Hills, MI
National Provider Identifier
1831890722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6361003116
- Practice address
- 6905 Telegraph Rd Ste 105
Bloomfield Hills, MI 48301-3177 - Phone
- (248) 594-0487
- NPI assigned
- Mar 16, 2023
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6361003116 | MI | Primary |
Addresses
Primary practice location
6905 Telegraph Rd Ste 105
Bloomfield Hills, MI 48301-3177
Mailing address
6905 Telegraph Rd Ste 105
Bloomfield Hills, MI 48301-3177
Phone (248) 594-0487
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6361003116 | Other | MI | BOARD OF PSYCHOLOGY |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6361003116 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678924800000",
"number": "1831890722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6905 TELEGRAPH RD STE 105",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483013177",
"telephone_number": "248-594-0487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6905 TELEGRAPH RD STE 105",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483013177",
"telephone_number": "248-594-0487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLADSTONE",
"first_name": "BENORA",
"credential": "MA,LLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-16",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6361003116",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PSYCHOLOGY",
"identifier": "6361003116",
"state": "MI"
}
],
"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 Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.