DR. WALTER L. SOBOTA (NPI# 1912058363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912058363 |
| Entity Type | Individual |
| Full Name | DR. WALTER L. SOBOTA |
| Credential | PH.D. |
| Practice Address |
25600 Woodward Ave S-107 Royal Oak MI 48067-0943 |
| Mailing Address |
343 Tara Dr Troy MI 48085-3119 |
| Practice Telephone | 2485428421 |
| Practice Fax Number | 2485435719 |
| Mailing Telephone | 2488799644 |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | 6301001434 | MI | Behavioral Health & Social Service Providers |
| X | 103TC0700X |
Psychologist Specialization: Clinical |
6301001434 | MI | Behavioral Health & Social Service Providers |
| Street Address |
25600 WOODWARD AVE S-107 |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48067-0943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942292354 | John Francis O'leary | Clinical Neuropsychologist | 25600 Woodward Ave, Suite 107, Royal Oak, MI 48067-0943 | 2005-08-22 |
| 1730617358 | Melissa E Mendoza Inc | Social Worker | 25600 Woodward Ave, Royal Oak, MI 48067-0943 | 2017-05-26 |
| 1053787457 | Mark Mcmillan | Social Worker | 25600 Woodward Ave, Ste 215, Royal Oak, MI 48067-0945 | 2015-08-19 |
| 1881087674 | Joe Kort & Associates, P.C. | Social Worker | 25600 Woodward Ave, Suite 215, Royal Oak, MI 48067-0943 | 2015-03-18 |
| 1578955670 | Paula Kirsch | Social Worker | 25600 Woodward Ave, Suite 215, Royal Oak, MI 48067-0943 | 2015-02-26 |
| 1467700971 | Matt Sweet Msw PC | Counselor | 25600 Woodward Ave, Suite 100, Royal Oak, MI 48067-0943 | 2012-08-15 |
| 1659511947 | Dana Ellen Macmillan M D P L L C | Psychiatry & Neurology | 25600 Woodward Ave, Suite 101, Royal Oak, MI 48067-0943 | 2009-02-25 |
| 1528216173 | Kelli Ann Weller | Counselor | 25600 Woodward Ave, Suite 215, Royal Oak, MI 48067-0943 | 2008-09-08 |
| 1871771600 | Diane Levy-rubinstein | Social Worker | 25600 Woodward Ave, Suite 215, Royal Oak, MI 48067-0943 | 2008-02-04 |
| 1760604938 | Naomi V Casement | Social Worker | 25600 Woodward Ave, #205, Royal Oak, MI 48067-0943 | 2007-05-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609072 | George Edward Khamis | Psychologist | 25600 Woodward Avenue, Suite 215, Royal Oak, MI 48067 | 2020-11-05 |
| 1205443751 | Crossover Health Medical Group | Clinic/Center | 424 E. 4th St, Suite 100, Royal Oak, MI 48067 | 2020-09-29 |
| 1750917811 | Sonia B Shah-gonzalez | Case Management | 830 E Fourth St, #1, Royal Oak, MI 48067 | 2020-03-19 |
| 1568022960 | Woodo Pharmacy LLC | Pharmacy | 909 E 11 Mile Rd, Royal Oak, MI 48067 | 2019-06-18 |
| 1093217564 | Sharon Diane Malinowski | Occupational Therapist | 4949 Coolidge Hwy Section E, Adult Neuro Ot, Royal Oak, MI 48067 | 2018-03-01 |
| 1962916569 | Nuch of Michigan Inc | Clinic/Center | 2140 E 12 Mile Rd, Royal Oak, MI 48067 | 2017-11-20 |
| 1629420179 | Christine Paige | Homeopath | 1112 Catalpa, Royal Oak, MI 48067 | 2016-07-08 |
| 1104277045 | Rppc Labs, LLC | Clinical Medical Laboratory | 26154 Woodward Ave Ste 5, Royal Oak, MI 48067 | 2016-06-22 |
| 1346606423 | Thomas Michalos | Counselor | 402 S. Lafayette, Royal Oak, MI 48067 | 2016-01-05 |
| 1508234212 | Valetta Aldridge | Registered Nurse | 28000 Woodward, Royal Oak, MI 48067 | 2015-09-11 |
| Find all providers in zip 48067 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942292354 | John Francis O'leary | Clinical Neuropsychologist | 25600 Woodward Ave, Suite 107, Royal Oak, MI 48067-0943 | 2005-08-22 |
| 1629283304 | Walter John Baker | Clinical Neuropsychologist | 32121 Woodward Ave, Suite 201, Royal Oak, MI 48073-6237 | 2007-05-14 |
| 1750505418 | John F Oleary Ph.d. | Clinical Neuropsychologist | 25600 Woodward Ave, Suite 107, Royal Oak, MI 48067-0943 | 2007-04-12 |
| 1891840336 | Psychological Systems Inc | Clinical Neuropsychologist | 32121 Woodward Ave, Suite 201, Royal Oak, MI 48073-6237 | 2007-01-24 |
| 1003984907 | Diane Karle | Clinical Neuropsychologist | 4949 Coolidge Hwy, Royal Oak, MI 48073-1026 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265046098 | Axon Psychology Group, PC | Clinical Neuropsychologist | 1377 Stonecreek Ct, Saint Joseph, MI 49085-9795 | 2020-08-31 |
| 1548814965 | Emily Nicole Robinett-ferrara | Clinical Neuropsychologist | 14050 Kingston St, Oak Park, MI 48237-1140 | 2019-07-25 |
| 1649782244 | Matthew Kadrich | Clinical Neuropsychologist | 3334 Rochester Rd # 205, Troy, MI 48083-5426 | 2017-11-04 |
| 1992237176 | Lauren Marie Golla | Clinical Neuropsychologist | 111 E Court St Ste 1b, Flint, MI 48502-1649 | 2017-03-28 |
| 1750839783 | Ace Psychological Consultants LLC | Clinical Neuropsychologist | 1920 Livernois Rd Ste D, Troy, MI 48083-1770 | 2016-09-20 |
| 1922556406 | Kenya Hameed | Clinical Neuropsychologist | 111 East Court St, Suite 1b-1, Flint, MI 48502 | 2016-09-14 |
| 1841609369 | Crystal Young | Clinical Neuropsychologist | 1550 E Beltline Ave Se, Suite 340, Grand Rapids, MI 49506-4301 | 2014-08-08 |
| 1497165146 | Woojin Song | Clinical Neuropsychologist | 2101 Commonwealth Blvd Ste C, Ann Arbor, MI 48105-2969 | 2014-05-03 |
| 1831516152 | Ira Lourie, Psy.d., Pllc | Clinical Neuropsychologist | 30051 High Valley Rd, Farmington Hills, MI 48331-2144 | 2014-03-25 |
| 1306272042 | Erin Mark | Clinical Neuropsychologist | 2010 Hogback Rd Ste 6g, Ann Arbor, MI 48105-8800 | 2013-09-25 |
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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.