Jamie E McGillivary, MS, LLP, BCBA

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

6301011704 Issued in MI

Practice address

1695 W 12 Mile Rd
120
Berkley, MI 48072-2182

Phone

(248) 691-4774

Fax

(248) 691-8129

NPI assigned

Sep 27, 2007

Last updated

Dec 17, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Healing Haven, LLC

  • Rehabilitation Clinic/Center
  • Madison HTS, MI
  • NPI 1598352924
  NPD Authorized official
• Healing Haven, LLC

  • Developmental Disabilities Clinic/Center
  • Madison Heights, MI
  • NPI 1790110187
  NPD Authorized official

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1467649061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 W 12 MILE RD",
            "address_2": "120",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480722182",
            "telephone_number": "248-691-4774",
            "fax_number": "248-691-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 W 12 MILE RD",
            "address_2": "120",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480722182",
            "telephone_number": "248-691-4774",
            "fax_number": "248-691-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILLIVARY",
        "first_name": "JAMIE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "MS, LLP, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-27",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301011704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carianne Taylor McCalden, M.A.
• Margaret Ann McCarthy, R.N. GNP-BC
• Carol Beth McCreary, R N
• Christopher William McFadden, P.A.
• Derek McGaughey, ATC
• McGuffey Home Health Care, LLC
• Jacob Benjamin Mechlowitz, DPM
• Medshop Pharmacy LLC
• Jeffrey A Meer, M.D.
• Isabella Mekani

• Clinical Child & Adolescent Psychologist in Berkley, MI
• Providers in Berkley, MI by specialty
• Clinical Child & Adolescent Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.