Organization Active NPI

Jenni Knowles, PH.D., LP, LLC

  • Clinical Psychologist
  • Troy, MI
National Provider Identifier
1336409804
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014248 Issued in MI
Legal business name
JENNI KNOWLES, PH.D., LP, LLC
Practice address
200 E Big Beaver Rd # 116
Troy, MI 48083-1208
Phone
(248) 320-1196
NPI assigned
May 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Authorized official

Name
Dr. Linda Knowles, LPNPI 1043431141
Title
Sole Proprietor
Phone
(248) 320-1196

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301014248 MI Primary

Addresses

Primary practice location

200 E Big Beaver Rd # 116
Troy, MI 48083-1208

Mailing address

6633 Ellinwood Dr
White Lake, MI 48383-3083
Phone (248) 320-1196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121214000074 MI Part B Supplier - Clinic/Group Practice 3971755109 Receives reassigned benefits from 1 practitioner
Practice locations: Highland, MI

National Provider Directory

National Provider Directory

Locations

141 N Milford Rd
Ste 201
Highland, MI 48357
Phone (248) 320-1196

41820 6 Mile Rd
Ste 104
Northville, MI 48168
Phone (248) 349-3131

200 E Big Beaver Rd
#116
Troy, MI 48083
Phone (248) 320-1196

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1336409804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6633 ELLINWOOD DR",
            "city": "WHITE LAKE",
            "state": "MI",
            "postal_code": "483833083",
            "telephone_number": "248-320-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E BIG BEAVER RD # 116",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831208",
            "telephone_number": "248-320-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNI KNOWLES, PH.D., LP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-18",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "KNOWLES",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "248-320-1196",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.