NPIMap

Organization Active NPI

Bay Psychological Services

  • Clinical Psychologist
  • Traverse City, MI
National Provider Identifier
1487712642
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301007636 Issued in MI
Legal business name
BAY PSYCHOLOGICAL SERVICES
Practice address
236 1/2 E Front St
Traverse City, MI 49684-2526
Phone
(231) 946-6488
Fax
(231) 275-0153
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Authorized official

Name
Dr. Jennifer J. Sowle, PHD
Title
Licensed Psychologist
Phone
(231) 946-6488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301007636 MI Primary

Addresses

Primary practice location

236 1/2 E Front St
Traverse City, MI 49684-2526

Mailing address

PO Box 4249
Traverse City, MI 49685-4249
Phone (231) 946-6488

National Provider Directory

National Provider Directory

Locations

236 E Front St
Traverse City, MI 49684
Phone (231) 946-6488

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1487712642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4249",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496854249",
            "telephone_number": "231-946-6488",
            "fax_number": "231-275-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 1/2 E FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842526",
            "telephone_number": "231-946-6488",
            "fax_number": "231-275-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "SOWLE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "231-946-6488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.