J FLACK PSYD PC (NPI# 1770859001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770859001 |
| Entity Type | Organization |
| Organization Name | J FLACK PSYD PC |
| Other Organization Name | FENTON WELLNESS |
| Practice Address |
127 N River St Fenton MI 48430-3800 |
| Practice Telephone | 8103099355 |
| Mailing Telephone | 8103099355 |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |
| Authorized Official Name | DR. JENNIFER FLACK (PRESIDENT) |
| Authorized Official Telephone | 8103099355 |
| Authorized Official Credential | PSY.D., LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 6401006094 | MI | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | 6801006671 | MI | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | 6301014240 | MI | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Fenton Wellness | Doing Business As Name - Organization |
| Street Address |
127 N RIVER ST |
| City | FENTON |
| State | MI |
| Zip Code | 48430-3800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821034638 | Hugh Urban Armbruster | Psychologist | 127 N River St, Fenton, MI 48430-3800 | 2006-06-21 |
| 1497316848 | Sheila Marie Gault | Counselor | 127 N River St, Fenton, MI 48430-3800 | 2019-06-26 |
| 1598246175 | John Edward Ross | Psychologist | 127 N River St, Fenton, MI 48430-3800 | 2018-08-22 |
| 1891218061 | Lisa Klammer | Counselor | 127 N River St, Fenton, MI 48430-3800 | 2017-07-19 |
| 1528455573 | Rebecca Seaward | Counselor | 127 N River St, Fenton, MI 48430-3800 | 2015-04-16 |
| 1386964278 | Fenton Wellness | Counselor | 127 N River St, Fenton, MI 48430-3800 | 2010-06-03 |
| 1922328996 | Nancy Elizabeth Armbruster | Counselor | 127 N River St, Fenton, MI 48430-3800 | 2010-06-01 |
| 1821221631 | Jennifer Lenore Flack | Psychologist | 127 N River St, Fenton, MI 48430-3800 | 2009-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1225515091 | Erica Anderson | Social Worker | 127 River St., Fenton, MI 48430 | 2018-07-25 |
| 1245767888 | Optimum Balance | Clinic/Center | 1537 N. Leroy Street, Suite D, Fenton, MI 48430 | 2017-05-14 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1366994410 | Intentional Wellbeing LLC | Psychologist | 1122 N. Leroy Rd, Suite A, Fenton, MI 48430 | 2016-10-25 |
| 1265801625 | Shawn Marie Gorkiewicz | Nurse Practitioner | 435 North Leroy, Fenton, MI 48430 | 2015-09-16 |
| 1972994226 | Carrie Hamilton | Physical Medicine & Rehabilitation | 102 N Adelaide St Ste B, Fenton, MI 48430 | 2015-02-09 |
| 1104222520 | Wellbridge of Fenton, LLC | Skilled Nursing Facility | 901 Pine Creek Drive, Fenton, MI 48430 | 2014-11-12 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1437569647 | Therapy Support Center LLC | Clinic/Center | 113 North River Street, Fenton, MI 48430 | 2014-04-28 |
| Find all providers in zip 48430 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649617317 | Joshua Mack Johnson | Psychologist | 1918 Georgetown Pkwy, Fenton, MI 48430-3223 | 2013-06-04 |
| 1003157520 | Lauren Ann Lay | Psychologist | 202 W Shiawassee Ave Ste 213, Fenton, MI 48430-2093 | 2013-03-07 |
| 1821034638 | Hugh Urban Armbruster | Psychologist | 127 N River St, Fenton, MI 48430-3800 | 2006-06-21 |
| 1942276928 | Jodie Gail Eckleberry-hunt | Psychologist | 2951 W. Shiawassee Ave, Fenton, MI 48430 | 2006-02-28 |
| 1548759541 | Fenton Therapy Services LLC | Psychologist | 1440 Torrey Rd Ste E, Fenton, MI 48430-1340 | 2018-05-04 |
| 1306376546 | Agius Psychological Services, LLC | Psychologist | 1440 Torrey Rd Ste E, Fenton, MI 48430 | 2017-06-19 |
| 1609320084 | Kristin Micheal | Psychologist | 1440 Torrey Rd Ste E, Fenton, MI 48430-1340 | 2016-08-15 |
| 1437500436 | Savanna Loafman | Psychologist | 1440 Torrey Rd Ste E, Fenton, MI 48430 | 2016-06-30 |
| 1659762441 | Johnathan Agius | Psychologist | 1440 Torrey Rd Ste E, Fenton, MI 48430 | 2015-02-15 |
| 1811311871 | Myriam Jensen | Psychologist | 113 N River St, Fenton, MI 48430-8998 | 2014-02-11 |
| Find all providers in FENTON | ||||
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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.