CHRISTINE BETH WILSON DE MEDINA (NPI# 1144887936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144887936 |
| Entity Type | Individual |
| Full Name | CHRISTINE BETH WILSON DE MEDINA |
| Credential | M.S.,L.L.P. |
| Practice Address |
W-4111 Andover Road Bloomfield Hills MI 48302 |
| Mailing Address |
17719 Odyssey Belleville MI 48111-9152 |
| Practice Telephone | 2482905400 |
| Mailing Telephone | 2489436151 |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-05-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | L915934 | MI | Behavioral Health & Social Service Providers |
| Street Address |
W-4111 ANDOVER ROAD |
| City | BLOOMFIELD HILLS |
| State | MI |
| Zip Code | 48302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386242634 | Lamuriel Lewis | Registered Nurse | 1430 South Telegraph Rd, Bloomfield Hills, MI 48302 | 2020-10-09 |
| 1730794082 | Ola Glezen | Registered Nurse | 1410 South Telegraph Road, Bloomfield Hills, MI 48302 | 2020-09-14 |
| 1114563400 | Henry Ford Health System | Pharmacy | 1961 S Telegraph Rd, Bloomfield Twp, MI 48302 | 2019-11-21 |
| 1508407982 | P-cor LLC | Eyewear Supplier (Equipment, not the service) | 1961 S. Telegraph Rd, Bloomfield Hills, MI 48302 | 2019-10-07 |
| 1942793799 | Andrew Joseph Grix | Physical Therapist | 2525 S Telegraph Rd Ste 314, Bloomfield Hills, MI 48302 | 2018-06-06 |
| 1306398078 | Shaleene Mayo | Mechanotherapist | 43902 Woodward # 120, Bloomfield Hills, MI 48302 | 2016-10-28 |
| 1588112981 | Carol Van Kampen | Social Worker | 2550 S. Telegraph, Bloomfield Hills, MI 48302 | 2016-09-14 |
| 1770933848 | Rachelle Savalli | Family Medicine | 1961 South Telegraph Rd, Bloomfield Twp, MI 48302 | 2016-06-20 |
| 1699155366 | Aleksey Mishulin | Ophthalmology | 1750 S Telegraph Ste 205, Bloomfield Hills, MI 48302 | 2015-06-08 |
| 1992190243 | Telegraph Urgent Care Pllc | Clinic/Center | 2510 S Telegraph, Suite C, Bloomfield Hills, MI 48302 | 2015-04-03 |
| Find all providers in zip 48302 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891276531 | Madison Kanka | Psychologist | 43996 Woodward Ave Ste 10, Bloomfield Hills, MI 48302-5030 | 2018-08-21 |
| 1497272496 | Monarch Behavioral Health, Pllc | Psychologist | 35980 Woodward Ave Ste 100, Bloomfield Hills, MI 48304-0903 | 2017-08-29 |
| 1174970735 | Ryan J. Brooks | Psychologist | 829 Thorntree Ct, Bloomfield Hills, MI 48304-3778 | 2016-05-24 |
| 1740623016 | Tamara Kolton | Psychologist | 74 W Long Lake Rd Ste 100, Bloomfield Hills, MI 48304-2770 | 2013-04-16 |
| 1952500621 | Emanuel T Vanbolden | Psychologist | 42335 Woodward Ave, Bloomfield Hills, MI 48304-5040 | 2007-07-13 |
| 1962625608 | Susan J Darlington | Psychologist | 7087 Lindenmere Ct, Bloomfield Hills, MI 48301-3504 | 2007-04-11 |
| 1780745935 | Hei Sook Wilkinson | Psychologist | 708 Parkman Dr, Bloomfield Hills, MI 48304-2448 | 2006-12-12 |
| 1598842908 | Sally Bloch | Psychologist | 4190 Telegraph Rd Ste 2700, Bloomfield Hills, MI 48302-2042 | 2006-11-01 |
| 1063595155 | Janice Marie Elsman | Psychologist | 7457 Franklin Rd, Suite 303, Bloomfield Hills, MI 48301-3611 | 2006-10-23 |
| 1801823257 | Nicole Ehart | Psychologist | 300 E Long Lake Rd Ste 130, Bloomfield Hills, MI 48304 | 2006-06-28 |
| Find all providers in BLOOMFIELD HILLS | ||||
| City | BLOOMFIELD HILLS |
| Zip Code | 48302 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.