Active NPI
Jaclynn George, L.L.P.C.
- Professional Counselor
- Troy, MI
National Provider Identifier
1013381797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401014867
- Practice address
- 2501 Rochester CT
Troy, MI 48083-1875 - Phone
- (248) 266-0453
- NPI assigned
- Nov 18, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401014867 | MI | Primary |
Addresses
Primary practice location
2501 Rochester CT
Troy, MI 48083-1875
Mailing address
3177 Newbury PL
Troy, MI 48084-7033
Phone (248) 266-0453
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401014867 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447804800000",
"number": "1013381797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3177 NEWBURY PL",
"city": "TROY",
"state": "MI",
"postal_code": "480847033",
"telephone_number": "248-266-0453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 ROCHESTER CT",
"city": "TROY",
"state": "MI",
"postal_code": "480831875",
"telephone_number": "248-266-0453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "JACLYNN",
"credential": "L.L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-18",
"last_updated": "2015-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401014867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.