Individual provider Active NPI

Jenna Debryn, MA, LPC, ATR

  • Counselor
  • Detroit, MI
National Provider Identifier
1164905675
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401019091 Issued in MI
Practice address
3584 W Outer Dr
Detroit, MI 48221-1662
Phone
(504) 407-1713
NPI assigned
Sep 11, 2018
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401019091 MI Primary
Art Therapist 221700000X 20-417 MI

Addresses

Primary practice location

3584 W Outer Dr
Detroit, MI 48221-1662

Mailing address

3584 W Outer Dr
Detroit, MI 48221-1662
Phone (248) 396-4602

Other practice location 1

801 W 11 Mile Rd Ste 100
Royal Oak, MI 48067-5200
Phone (248) 238-8050

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 Arts

State licenses

LicenseStateTypeSpecialty
6401019091MIMDCounselor
20-417MIMDArt Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Artsoul Therapy LLC Counselor CurrentSince Sep 23, 2021 Accepting new patients
Creative Growth Therapy Counselor CurrentSince Mar 21, 2021 Accepting new patients
Variety Far Conservatory PastSince Jan 31, 2021 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1164905675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3584 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482211662",
            "telephone_number": "248-396-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3584 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482211662",
            "telephone_number": "504-407-1713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 W 11 Mile Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480675200",
            "country_code": "US",
            "telephone_number": "248-238-8050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBRYN",
        "first_name": "JENNA",
        "credential": "MA, LPC, ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401019091",
            "primary": true
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "MI",
            "license": "20-417",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.