Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1740316983 Deactivated / Inactive NPI Male Practitioner

Dr. Nick Boneff , PhD

Psychologist - Clinical • Dearborn, MI

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Nick Boneff has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 24, 2007
NPI Deactivation Date October 20, 2022
Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Nick Boneff, PhD was a registered Psychologist - Clinical practicing in Dearborn, MI. Throughout an active medical career spanning 15 years, Dr. Boneff provided care at the practice location at 19855 OUTER DR until profile deactivation on 2022-10-20.

Practice Location & Contact Primary Location

Practice Address

19855 Outer Dr
Suite 200-East

Dearborn, MI 481242022

Telephone 3132748360
Fax 2485494215
Associated Practice Facility / Clinic
🏢 Penelope Hale Phd Pc Facility NPI 1346411220

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Clinical in Dearborn, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.0 Yrs
State Avg: 23.3 Yrs
Regional Practice Density
55 Specialists

Practicing in Dearborn, MI (3104 Statewide)

Telehealth Adoption Rate
14.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist - Clinical Primary Specialty

NUCC Taxonomy Code: 103TC0700X

State License MI 6301005549

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
NPI 1023368396

Licensed Professional Counselor, SW

Dr. James Fordyce , MD

Allergy & Immunology - Clinical & Laboratory Immunology

NPI 1215905765

Doctor of Medicine (M.D.)

Michele Dombrowski , LMSW

Social Worker - Clinical

NPI 1366867699

Licensed Master Social Worker

Dr. Paris Miller , PhD

Psychologist - Clinical

NPI 1457529232

Doctor of Philosophy (Ph.D.)

Dr. Penelope Hale , PhD

Psychologist - Clinical

NPI 1700961158

Doctor of Philosophy (Ph.D.)

Dr. Diane Baranowski , MD

Allergy & Immunology - Clinical & Laboratory Immunology

NPI 1750359204

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated October 20, 2022

Record deactivated on October 20, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 19855 OUTER DR, SUITE 200-EAST, DEARBORN, MI 481242022 (Tel: 3132748360)

📍
Updated Business Mailing Address July 08, 2007

Registered at 19855 OUTER DR, SUITE 200-EAST, DEARBORN, MI 481242022 (Tel: 3132748360)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as NICK BONEFF, PH.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #6301005549 in MI)

🟢
Initial NPI Registration & Enumeration February 24, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Nick Boneff. Be the first to share your experience!

Sign in to leave a review for Dr. Nick Boneff

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1740316983
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 24, 2007
Last Update: July 08, 2007
Deactivation Date: October 20, 2022

Mailing Address

19855 Outer Dr, Suite 200-East

Dearborn, MI 481242022

Phone: 3132748360

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.