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NPI Code Detail

MEDICARE: DR. JUDITH A BEAN PHD

MEDICARE:  DR. JUDITH A BEAN  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist6301001417MI
2103TA0400XAddiction (Substance Use Disorder) Psychologist6301001417MI
3103TA0700XAdult Development & Aging Psychologist6301001417MI
4103TB0200XCognitive & Behavioral Psychologist6301001417MI
5103TC0700XClinical Psychologist6301001417MI
6103TC1900XCounseling Psychologist6301001417MI
7103TC2200XClinical Child & Adolescent Psychologist6301001417MI
8103TF0000XFamily Psychologist6301001417MI
9103TF0200XForensic Psychologist6301001417MI
10103TM1800XIntellectual & Developmental Disabilities Psychologist6301001417MI
11103TP2701XGroup Psychotherapy Psychologist6301001417MI
12103TS0200XSchool Psychologist6301001417MI

General Provider Information

NPI Number : 1306999628
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDITH A BEAN PHD
Provider Business Mailing Address
First Line : 1937 LONE PINE RD
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48302-2522
Country : US
Telephone Number : 248-626-9729
Fax Number : 248-626-3299
Provider Business Practice Location Address
First Line : 24500 FORD RD
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-3182
Country : US
Telephone Number : 313-563-0919
Fax Number : 313-563-0826
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 04/25/2008

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Directions to “ DR. JUDITH A BEAN PHD” Practice Location

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