NPIMap

Organization Active NPI

Arbor Psychology Group, PLLC

  • Clinical Psychologist
  • Plymouth, MI
National Provider Identifier
1952789877
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301013977 Issued in MI
Legal business name
ARBOR PSYCHOLOGY GROUP, PLLC
Practice address
44450 Pinetree Dr
Suite 101
Plymouth, MI 48170-3869
Phone
(734) 738-0897
Fax
(734) 738-0898
NPI assigned
May 12, 2015
Last updated
May 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Authorized official

Name
Dr. Michael Andrew Bambery, PH.D.NPI 1215128608
Title
Owner/Director
Phone
(734) 738-0897

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301013977 MI Primary

Addresses

Primary practice location

44450 Pinetree Dr
Suite 101
Plymouth, MI 48170-3869

Mailing address

44450 Pinetree Dr
Suite 101
Plymouth, MI 48170-3869
Phone (734) 738-0897

Other names 1

  • Arbor Psychology Group, LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181001002925 MI Part B Supplier - Clinic/Group Practice 3678824612 Receives reassigned benefits from 4 practitioners
Practice locations: Plymouth, MI

National Provider Directory

National Provider Directory

Locations

44450 Pinetree Dr
Ste 101
Plymouth, MI 48170
Phone (734) 738-0897

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1952789877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44450 PINETREE DR",
            "address_2": "SUITE 101",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703869",
            "telephone_number": "734-738-0897",
            "fax_number": "734-738-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44450 PINETREE DR",
            "address_2": "SUITE 101",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703869",
            "telephone_number": "734-738-0897",
            "fax_number": "734-738-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBOR PSYCHOLOGY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "BAMBERY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "734-738-0897",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arbor Psychology Group, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.