Gwendolyn Brimble, MA, MS LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301014422 Issued in MI

Practice address

47818 Van Dyke Ave
Shelby TWP, MI 48317-3373

Phone

(586) 323-3620

NPI assigned

Oct 26, 2015

Last updated

Oct 26, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Expert Mental Health PLLC

  • Clinical Psychologist
  • Berkley, MI
  • NPI 1518808021
  NPD Authorized official
• Clementine Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shelby TWP, MI
  • NPI 1265360739
  NPD (past)
• Hamzavi Psychiatry & Wellness Center PLLC

  • Psychiatry Physician
  • Farmington Hills, MI
  • NPI 1891188124
  NPD (past)
• United Psychological Services Inc

  • Clinical Neuropsychologist
  • Shelby TWP, MI
  • NPI 1407947658
  NPD (past)

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1912379298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47818 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483173373",
            "telephone_number": "586-323-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47818 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483173373",
            "telephone_number": "586-323-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIMBLE",
        "first_name": "GWENDOLYN",
        "credential": "MA, MS LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karley Ann Blumke
• Jennifer Lynn Bochenek
• Kimberly Bonikowski, COTAL
• Daniel David Bortolotti, D.D.S.
• Shayna Brickman
• Jenna Judith Briney, DDS
• Rebekah Bronson
• Brostek Family Chiropractic PLLC
• Sara Brostek, D.C.
• Robyn Brown

• Clinical Psychologist in Shelby TWP, MI
• Providers in Shelby TWP, MI by specialty
• Clinical Psychologist in Michigan

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