JACLYN RECKOW


Address: 245 Cherry St Se Ste 104, Grand Rapids, MI 49503-4607
Phone: 6166855050

JACLYN RECKOW (NPI# 1144717604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144717604
Entity Type Individual
Full Name JACLYN RECKOW
Credential PHD
Practice Address 245 Cherry St Se Ste 104
Grand Rapids
MI 49503-4607
Mailing Address 1900 44th St Se
Kentwood
MI 49508-5008
Practice Telephone 6166855050
Practice Fax Number 6166858962
Enumeration Date 2018-04-19
Last Update Date 2018-04-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist 6301016942 MI Behavioral Health & Social Service Providers

Office Location

Street Address 245 CHERRY ST SE STE 104
City GRAND RAPIDS
State MI
Zip Code 49503-4607

Providers in the same location

NPI Name Taxonomy Address Enumeration
1598101115 Rebecca Smith Tang Psychiatry & Neurology 245 Cherry St Se Ste 104, Grand Rapids, MI 49503-4607 2013-05-22

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NPI Name Taxonomy Address Enumeration
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1730707282 Adriana Molina-schmuker Counselor 901 Eastern Avenue Ne, Grand Rapids, MI 49503 2020-07-10
1477176949 Kimberly Buskirk Specialist 1131 Ionia Ava Nw, Grand Rapids, MI 49503 2020-05-19
1124647805 Jared Host Speech-Language Pathologist Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 2020-04-13
1265061378 Heather Gladfelter Student in an Organized Health Care Education/Training Program 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 2020-04-02
1194368647 Amy Jo Arends Nurse Practitioner 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 2019-10-28
1376185199 Beth Arce Occupational Therapist 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 2019-10-14
1295387256 Althea Ziolkowski Licensed Practical Nurse Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 2019-07-10
1790340719 Heather Anne Fox Occupational Therapist Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 2019-05-06
1184182883 April L Kaiserlian Social Worker 983 Spaulding Ave Ne, Ada, MI 49503 2019-03-12
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1841609369 Crystal Young Clinical Neuropsychologist 1550 E Beltline Ave Se, Suite 340, Grand Rapids, MI 49506-4301 2014-08-08
1861686784 Lauren Elizabeth Spoon Clinical Neuropsychologist 3333 36th St Se, Grand Rapids, MI 49512-2809 2007-09-04
1538287495 James Bernard De Boe Clinical Neuropsychologist 4131 Embassy Dr Se, Grand Rapids, MI 49546-2418 2007-03-27
1891867495 Cherry Street Services, Inc. Clinical Neuropsychologist 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 2006-11-15
1477663599 Don Allen Boyd Clinical Neuropsychologist 3300 Burton St Se Ste B, Grand Rapids, MI 49546-4398 2006-08-30
1598705675 Thomas Charles Fuller Clinical Neuropsychologist 161 Ottawa Nw, Ste 300c, Grand Rapids, MI 49503-2707 2006-06-07
1447738877 Draycen Decator Clinical Neuropsychologist 3292 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 2018-07-28
1184172496 Jesse J Piehl Clinical Neuropsychologist 3292 Evergreen Dr Ne, Grand Rapids, MI 49525-9580 2016-09-15
1144678020 Alicia Beth Vanden Bussche Jantz Clinical Neuropsychologist 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 2016-06-01
1619346285 Brianne Alyse Brooker Clinical Neuropsychologist 35 Michigan St Ne Ste 5201, Grand Rapids, MI 49503-2530 2015-09-24
Find all providers in GRAND RAPIDS

Competitor

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City GRAND RAPIDS
Zip Code 49503

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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