Dr. Jennifer B. Mainka, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301014583 Issued in MI

Legal business name

DR. JENNIFER B. MAINKA, LLC

Doing business as

Renewed Relationships Counseling and Psychological Services

Practice address

2300 Genoa Business Park Dr
Suite 160
Brighton, MI 48114-7367

Phone

(810) 522-0785

Fax

(810) 229-5337

NPI assigned

Oct 31, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Boss Mainka, PH.D.

Title

Psychologist

Phone

(248) 444-2418

Specialties & licenses 1

Addresses

Other names 1

• Renewed Relationships Counseling and Psychological Services Doing business as

Locations

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418601600000",
    "number": "1316342447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 GENOA BUSINESS PARK DR",
            "address_2": "SUITE 160",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147367",
            "telephone_number": "810-522-0785",
            "fax_number": "810-229-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GENOA BUSINESS PARK DR",
            "address_2": "SUITE 160",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147367",
            "telephone_number": "810-522-0785",
            "fax_number": "810-229-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JENNIFER B. MAINKA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-12-15",
        "status": "A",
        "authorized_official_last_name": "MAINKA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOSS",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "248-444-2418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renewed Relationships Counseling and Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Psychologist in Brighton, MI
• Providers in Brighton, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.