DR. JACK NOVICK (NPI# 1710158928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710158928 |
| Entity Type | Individual |
| Full Name | DR. JACK NOVICK |
| Credential | PH.D |
| Practice Address |
617 Stratford Dr Ann Arbor MI 48104-2745 |
| Practice Telephone | 7346656745 |
| Practice Fax Number | 7346652875 |
| Mailing Telephone | 7346656745 |
| Mailing Fax Number | 7346652875 |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-03-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
002202 | MI | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
002202 | MI | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
002202 | MI | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
002202 | MI | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
002202 | MI | Behavioral Health & Social Service Providers |
| N | 103TF0000X |
Psychologist Specialization: Family |
002202 | MI | Behavioral Health & Social Service Providers |
| N | 102L00000X | Psychoanalyst | 002202 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS | 0HI45566 | 01 |
| Street Address |
617 STRATFORD DR |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48104-2745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174794382 | Kerry Kelly Novick | Psychoanalyst | 617 Stratford Dr, Ann Arbor, MI 48104-2745 | 2008-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336603927 | Julie Corey | Counselor | 2604 Brockman Blvd, Ann Arbor, MI 48104 | 2019-01-28 |
| 1003301045 | Ann Arbor Pharmacy LLC | Pharmacy | 2418 E Stadium Blvd, Ann Arbor, MI 48104 | 2018-06-22 |
| 1811499304 | Melissa L Wright | Physical Therapist | 2850 S Industrial Hwy Suite 200, Ann Arbor, MI 48104 | 2018-03-01 |
| 1689180226 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3500 Washtenaw Ave Ste E3, Ann Arbor, MI 48104 | 2017-12-19 |
| 1861911547 | Jonathen Ross | Social Worker | 500 E. Washington St., Ste 100a, Ann Arbor, MI 48104 | 2017-09-14 |
| 1275058521 | Emily Lauren Hanna | Social Worker | 214 S. Main Street, Suite # 206, Ann Arbor, MI 48104 | 2017-08-08 |
| 1073035457 | Raynaldo Juaquin Valdez | Specialist/Technologist | 500 E. Hoover Ave, Ann Arbor, MI 48104 | 2017-07-07 |
| 1912436908 | Alison Nicole Tseng | Dentist | 2301 Platt Rd Ste 200, Ann Arbor, MI 48104 | 2017-06-05 |
| 1528593183 | Hillary Baldwin Steller, Lmsw,llc | Social Worker | 715-717 E. Huron St, Suite 2e, Ann Arbor, MI 48104 | 2017-04-20 |
| 1013360973 | Teresa Myers | Massage Therapist | 2230 Washtenaw Ave, Suite 101, Ann Arbor, MI 48104 | 2016-07-15 |
| Find all providers in zip 48104 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053925685 | Davia Steinberg Ogg, Ph.d., LLC | Psychologist | 300 N 5th Ave Ste 200, Ann Arbor, MI 48104-1447 | 2020-09-01 |
| 1730798794 | Joshua Kay | Psychologist | 308 Arbana Dr, Ann Arbor, MI 48103-3706 | 2020-07-27 |
| 1295344216 | Aaron Sedlar | Psychologist | 2500 Packard St Ste 104a, Ann Arbor, MI 48104-6827 | 2020-07-27 |
| 1992320071 | Gohar Psychological Services, Pllc | Psychologist | 321 S Main St Ste 212, Ann Arbor, MI 48104-2128 | 2020-06-15 |
| 1578187688 | Richard Reinsmith | Psychologist | 1420 Iroquois Pl, Ann Arbor, MI 48104-4638 | 2020-06-04 |
| 1063991594 | Abadi Psychology, Pllc | Psychologist | 2350 Washtenaw Ave Ste 7, Ann Arbor, MI 48104-4525 | 2018-08-07 |
| 1982196523 | Karen Gottschalk Psychotherapy | Psychologist | 2350 Washtenaw Ave Ste 7g, Ann Arbor, MI 48104-4532 | 2018-05-30 |
| 1386133973 | Judy Seldin Psychotherapy, Plc | Psychologist | 2350 Washtenaw Ave Ste 7e, Ann Arbor, MI 48104-4532 | 2018-05-09 |
| 1356839351 | Adam Lafave | Psychologist | 3830 Packard St Ste 280, Ann Arbor, MI 48108-2276 | 2018-04-25 |
| 1841797941 | Integrated Counseling LLC | Psychologist | 2311 E Stadium Blvd Ste B5, Ann Arbor, MI 48104-4803 | 2018-04-06 |
| Find all providers in ANN ARBOR | ||||
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| 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.