Individual provider Active NPI

Jacqueline Adeline Meyers, PSY.D, LP, LPC, NCC

  • Psychologist
  • Wyandotte, MI
National Provider Identifier
1124006895
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301015288 Issued in MI
Practice address
2955 Biddle Ave Ste 200
Wyandotte, MI 48192-5231
Phone
(734) 991-3234
Fax
(734) 324-1566
NPI assigned
Jan 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401008214 MI
Psychologist 103T00000X 6301015288 MI Primary

Addresses

Primary practice location

2955 Biddle Ave Ste 200
Wyandotte, MI 48192-5231

Mailing address

3247 Biddle Ave Apt 2
Wyandotte, MI 48192-5951
Phone (734) 991-3234

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160208001656 MI Practitioner - Clinical Psychologist 0042514341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2955 Biddle Ave
Suite 200
Wyandotte, MI 48192-5231
Phone (586) 879-9579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401008214MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Strength Counseling Services PLCC Clinical Past Accepting new patients

Organizations & group practices 2

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1124006895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3247 BIDDLE AVE APT 2",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925951",
            "telephone_number": "734-991-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 BIDDLE AVE STE 200",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925231",
            "telephone_number": "734-991-3234",
            "fax_number": "734-324-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "JACQUELINE",
        "middle_name": "ADELINE",
        "name_prefix": "Dr.",
        "credential": "PSY.D, LP, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401008214",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301015288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.