1366758997 NPI number — DR. ERIKA LONDON BOCKNEK PHD, LMFT

Table of content: DR. ERIKA LONDON BOCKNEK PHD, LMFT (NPI 1366758997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366758997 NPI number — DR. ERIKA LONDON BOCKNEK PHD, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOCKNEK
Provider First Name:
ERIKA
Provider Middle Name:
LONDON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366758997
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27172 WOODWARD AVENUE SUITE 200
Provider Second Line Business Mailing Address:
RELATIONSHIP INSTITUTE
Provider Business Mailing Address City Name:
ROYAL OAK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48067
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-546-0407
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
27172 WOOD AVENUVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
ROYAL OAK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48067-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-546-0407
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  4101006313 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com