Midwest Neuro Forensics, PC

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

Organization subpart

No

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

Authorized official

Name

Dr. Kyle R Bonesteel, PH.D

Title

President

Phone

(630) 969-3233

Specialties & licenses 1

Addresses

Locations

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": []
}

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• Psychologist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Psychologist in Michigan

• 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.