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NPI Code Detail

MEDICARE: BRADFORD MICHAEL BEEBE PHD, HSPP, BCBA-D

MEDICARE: BRADFORD MICHAEL BEEBE PHD, HSPP, BCBA-D
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
1103K00000XBehavior Analyst101602KY
2103TC0700XClinical Psychologist20040970AIN
3103TC0700XClinical Psychologist128036KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21-04-2089OTHERBCBA-D CERTIFICATE

General Provider Information

NPI Number : 1356344469
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADFORD MICHAEL BEEBE PHD, HSPP, BCBA-D
Provider Business Mailing Address
First Line : 27777 INKSTER RD STE 100
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48334-5312
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5505 N POST RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46216-1000
Country : US
Telephone Number : 317-300-5725
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 05/16/2026

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