Individual provider Active NPI

Jennifer Marie Rizk, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1073330189
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704304766 Issued in MI
Practice address
3519 Dudley St
Dearborn, MI 48124-3639
Phone
(313) 333-7033
Fax
(415) 960-1323
NPI assigned
Sep 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704304766 MI Primary

Addresses

Primary practice location

3519 Dudley St
Dearborn, MI 48124-3639

Mailing address

3519 Dudley St
Dearborn, MI 48124-3639
Phone (313) 400-7661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241226003017 MI Practitioner - Nurse Practitioner 4082141346 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

39500 W 10 Mile Rd
Suite 108
Novi, MI 48375-2947
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704304766MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Psychiatry of Michigan PLLC CurrentSince Oct 24, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jun 18, 2025 Accepting new patients
Thrive Counseling LLC CurrentSince Aug 25, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

400 Renaissance Ctr
Detroit, MI 48243
Phone (248) 599-1582

250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616

39500 W 10 Mile Rd
Ste 108
Novi, MI 48375
Phone (248) 888-6800

524 E Milham Ave
Ste B
Portage, MI 49002
Phone (269) 264-4920

7333 Triangle Dr
Sterling Hts, MI 48314
Phone (248) 686-3347

34841 Veterans Plz
Wayne, MI 48184
Phone (313) 292-7640

375 Eureka Rd
Ste B
Wyandotte, MI 48192
Phone (734) 225-9300

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Interoperability endpoints

  • Direct secure messaging: purepsychiatrymi.jenniferrizk@153418.advancedmd-direct.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1073330189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3519 DUDLEY ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243639",
            "telephone_number": "313-400-7661",
            "fax_number": "415-960-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 DUDLEY ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243639",
            "telephone_number": "313-333-7033",
            "fax_number": "415-960-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZK",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-21",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704304766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.