Individual provider Active NPI

Christine Marie Reitzel, MS, LLP

  • Clinical Psychologist
  • Jackson, MI
National Provider Identifier
1114048766
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301012621 Issued in MI
Practice address
1522 Joy Ave
Jackson, MI 49203-1933
Phone
(517) 782-2551
Fax
(517) 783-1986
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301012621 MI Primary

Addresses

Primary practice location

1522 Joy Ave
Jackson, MI 49203-1933

Mailing address

33646 Alta St
Garden City, MI 48135-1081
Phone (734) 261-0378

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6301012621MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of Jackson, Lenawee and Hillsdale Counties PastSince Apr 1, 2008 Accepting new patients

Organizations & group practices 1

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1114048766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33646 ALTA ST",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481351081",
            "telephone_number": "734-261-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 JOY AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492031933",
            "telephone_number": "517-782-2551",
            "fax_number": "517-783-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITZEL",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "credential": "MS, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.