DR. BRADLEY NEAL AXELROD PH.D.
NPI 1316950678
Clinical Neuropsychologist in Detroit, MI

Q: What is Bradley Axelrod's NPI number?

The NPI number for Bradley Axelrod is 1316950678. It was assigned to this individual provider in the NPPES registry on August 15, 2006.

Q: What is Bradley Axelrod's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Axelrod was last updated on January 27, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 15, 2006PECOS Enrolled

4646 JOHN R ST, PSYCHOLOGY SECTION (11MH-PS), DETROIT, MI 48201(313) 576-1000 Get Directions Write a Review

NPPES record last updated: January 27, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Bradley Neal Axelrod Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRADLEY NEAL AXELROD PH.D. (NPI 1316950678) is an individual clinical neuropsychologist in Detroit, Michigan, licensed in Michigan (6301007688) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1989).

NPPES Registry Identity

NPI1316950678

Entity TypeIndividualMale

Primary Taxonomy103G00000X

Provider Legal NameDR. BRADLEY NEAL AXELRODCredential: PH.D.

Location Address4646 JOHN R ST, PSYCHOLOGY SECTION (11MH-PS)Detroit, MI 48201-1916

Mailing Address4646 John R St, Psychology Section (11mh-ps)Detroit, MI 48201-1916 · (313) 576-1000

Phone(313) 576-1000

Sole ProprietorYes

Medical School CMSOtherGraduated 1989

Enumeration DateAugust 15, 2006

Last NPPES UpdateJanuary 27, 2015

✔ NPI 1316950678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in MI · 6301007688

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 6301007688 (MI)

4646 JOHN R ST, Detroit, MI 48201

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Bradley Neal Axelrod Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6204322605

PECOS Enrollment IDI20260106002492

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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