NPIMap

Organization Active NPI

Midwest Neuro Forensics, PC

  • Psychologist
  • Sterling Heights, MI
National Provider Identifier
1962759415
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301013025 Issued in MI
Legal business name
MIDWEST NEURO FORENSICS, PC
Practice address
2609 Metropolitan Pkwy
Suite 300
Sterling Heights, MI 48310-4216
Phone
(586) 446-2225
Fax
(586) 446-2227
NPI assigned
Aug 14, 2012
Last updated
Aug 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Authorized official

Name
Dr. Kyle R Bonesteel, PH.DNPI 1194704213
Title
President
Phone
(630) 969-3233

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 6301013025 MI Primary

Addresses

Primary practice location

2609 Metropolitan Pkwy
Suite 300
Sterling Heights, MI 48310-4216

Mailing address

2609 Metropolitan Pkwy
Suite 300
Sterling Heights, MI 48310-4216
Phone (586) 446-2225

National Provider Directory

National Provider Directory

Locations

2609 Metropolitan Pkwy
Ste 300
Sterling Heights, MI 48310
Phone (586) 446-2225

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1962759415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 METROPOLITAN PKWY",
            "address_2": "SUITE 300",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104216",
            "telephone_number": "586-446-2225",
            "fax_number": "586-446-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 METROPOLITAN PKWY",
            "address_2": "SUITE 300",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104216",
            "telephone_number": "586-446-2225",
            "fax_number": "586-446-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST NEURO FORENSICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A",
        "authorized_official_last_name": "BONESTEEL",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-969-3233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.