JAYNE FABRY, PTC ASSOCIATES (NPI# 1952597767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952597767 |
| Entity Type | Organization |
| Organization Name | JAYNE FABRY, PTC ASSOCIATES |
| Other Organization Name | PROFESSIONAL THERAPY CONSULTATION |
| Practice Address |
1651 W Centre Ave Portage MI 49024-6312 |
| Practice Telephone | 2695529832 |
| Mailing Telephone | 2695529832 |
| Enumeration Date | 2007-09-15 |
| Last Update Date | 2008-08-12 |
| Authorized Official Name | JAYNE FABRY (OWNER) |
| Authorized Official Telephone | 2695529832 |
| Authorized Official Credential | CLINICAL PSYCHOL |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 6301008864 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 0C913440 | 01 |
| Other Name | Type Code |
|---|---|
| Professional Therapy Consultation | Doing Business As Name - Organization |
| Street Address |
1651 W CENTRE AVE |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-6312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053953208 | Amy Albertson | Counselor | 1651 W Centre Ave, Portage, MI 49024-6312 | 2019-10-09 |
| 1346789658 | Therapy App | Counselor | 1651 W Centre Ave, Suite 209, Portage, MI 49024-6312 | 2017-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| 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 |
|---|---|---|---|---|
| 1215593934 | Letetsia Fox | Psychologist | 1400 W Milham Ave, Portage, MI 49024-1209 | 2019-05-17 |
| 1912209156 | Shamika Hall | Psychologist | 7901 S 12th St Ste 201, Portage, MI 49024-3831 | 2010-11-19 |
| 1437342565 | Emily Walker Sherwood | Psychologist | 1604 Timberlane Dr, Portage, MI 49024-5705 | 2007-08-22 |
| 1083727192 | Lee Carlin Sanders | Psychologist | 10056 Woodlawn Dr, Portage, MI 49002-7207 | 2006-08-16 |
| 1235151333 | Joyce Scully | Psychologist | 78 Ski Hill Rd, Portage, IN 46368-8719 | 2006-07-25 |
| 1033169008 | Patricia Shull-blood | Psychologist | 5148 Lovers Ln, Suite 200, Portage, MI 49002-1572 | 2006-05-11 |
| 1649245655 | Patricia Ann Lyman | Psychologist | 5220 Lovers Ln, Suite 120, Portage, MI 49002-1599 | 2006-02-22 |
| 1477530392 | Michael V Bloom | Psychologist | 7920 Kirkland Ct, Portage, MI 49024-4974 | 2005-12-30 |
| 1598746778 | James Darrell Cowart | Psychologist | 5100 Lovers Ln, Trestlewood, Bldg. D, Portage, MI 49002-1558 | 2005-11-07 |
| 1073163580 | Michael V Bloom Phd LLC | Psychologist | 7920 Kirkland Ct, Portage, MI 49024-4974 | 2019-09-17 |
| Find all providers in PORTAGE | ||||
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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.