Jaclyn Grad OT LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

JACLYN GRAD OT LLC

Doing business as

Grow With Me OT

Practice address

11325 Blackburn St
Livonia, MI 48150-2853

Phone

(734) 292-1860

NPI assigned

Jul 10, 2023

Organization subpart

No

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

Authorized official

Name

Jaclyn Grad, OTRLNPI 1144699448

Title

Occupational Therapist

Phone

(734) 292-1860

Specialties & licenses 1

Addresses

Other names 1

• Grow With Me OT Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaclyn Grad

  • Occupational Therapist
  • Livonia, MI
  • NPI 1144699448
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1235817206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11325 BLACKBURN ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502853",
            "telephone_number": "734-292-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11325 BLACKBURN ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502853",
            "telephone_number": "734-292-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACLYN GRAD OT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-09",
        "status": "A",
        "authorized_official_last_name": "GRAD",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "734-292-1860",
        "authorized_official_credential": "OTRL"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grow With Me OT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul Jackson, D.O.
• Shantele Dennene Jackson
• Stephanie Jackson, LBSW, QMHP, QIDP
• Tayonna Jackson
• Zannie Roy Jackson Jr., PEER SUPPORT SPECIAL
• Jackson Jacob, CCP
• Kia Jacob
• Laith J Jacob, MD, MBCHB
• John Paul Jacobi, O.D., F.C.O.V.D.
• Austin Jacobs

• Occupational Therapist in Livonia, MI
• Providers in Livonia, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.