Individual provider Active NPI

Aiden Zamzow-Bunn

  • Clinical Psychologist
  • Novi, MI
National Provider Identifier
1922596006
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6362009457 Issued in MI
Practice address
41521 W 11 Mile Rd
Novi, MI 48375-1803
Phone
(248) 299-0030
NPI assigned
Apr 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6362009457 MI Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

41521 W 11 Mile Rd
Novi, MI 48375-1803

Mailing address

409 Plymouth Rd
Plymouth, MI 48170-1497

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

State licenses

LicenseStateTypeSpecialty
6362009457MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1922596006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 PLYMOUTH RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41521 W 11 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751803",
            "telephone_number": "248-299-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMZOW-BUNN",
        "first_name": "AIDEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362009457",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.